Hip Arthroscopic Surgery
Experiencing pain in the hip
If you experience any of these symptoms, please seek medical help. An orthopaedic surgeon can help to assess and confirm the labral tear in the hip with an MRI scan and a comprehensive medical assessment.
What is femoral acetabular impingement (FAI)?
Cam-type FAI occurs due to an extra bump of bone at the junction of the femoral head and neck. This extra bone collides or impinges on the labrum when moving the hip. Imagine having a small stone in your shoe! The soft labrum is therefore squeezed between the bony acetabulum and bony bump, and ends up tearing. If the bony bump is not removed and labrum is not repaired, the hip will become arthritic overtime.
Pincer-type FAI occurs when there is an overhanging or extra bone around the acetabulum. When the hip moves, the pincer crushes the soft labrum against the hard femoral neck, resulting in a severely damaged labrum and a painful hip. Some patients have a combined cam- and pincer-type, which worsens the symptoms.
Procedure: Arthroscopic labral repair
Traditionally, repair of the labrum involved open surgery and a large skin incision on the hip. These days, arthroscopic or keyhole surgery is performed for the same purpose. Small incisions allow wounds to heal faster, lower the risk of infection and reduce the collateral damage to other structures in the hip.
How is arthroscopic labral repair performed?
Several incisions between 1 to 2cm long are made around the hip. The instruments used for this procedure are long and thin, like chopsticks. It allows accurate localisation of the torn labrum and precise repair of the tear. Labral tears should also not be repaired in isolation. The offending cam bony bump or overhanging pincer must be addressed to prevent repeat tears in future.
What is recovery like?
Rehabilitation after surgery may take 3 to 6 months. In the early days after surgery, medication is given to manage general pain around the hip, ice is applied to reduce swelling and patients are not allowed to bend their hips beyond 90 degrees to protect the repair site. While the arthroscopic scars are small and heal within 2 weeks, patients are encouraged to attend frequent physiotherapy after surgery to prevent scarring in their hips, maintain muscle strength in the thighs and promote a smooth walking pattern. Cycling on a stationary bicycle is also important to get your hips going and prevent stiffness. Most patients return to brisk walking at about 3 months and eventually, sports at 6 months.
Will arthroscopic labral repair affect my daily lifestyle?
The intention of hip preservation surgery is to repair and patch up hip injuries, ultimately delaying the need for a formal hip replacement. If the damage in the hip is too severe and patients continue to have pain despite hip preservation surgery, then your orthopaedic surgeon will recommend a hip replacement.
There are misconceptions about hip replacements, mainly that they are reserved for elderly patients and that patients are unable to return to an active lifestyle after the surgery. This is not true. For more information, please see the article on “Hip Replacement Surgery”.
Speak to our orthopaedic surgeon if you are experiencing any pain in your hips, or want to know more about how we can help.