What Is Arthroscopy?
Arthroscopy refers to a minimally invasive surgical procedure that orthopedic surgeons use to diagnose and treat joint injuries. It involves making small incisions and using miniature instruments and an arthroscope, a tiny camera with a light that goes inside the joint.
Arthroscopic Surgery
You have probably heard of arthroscopic surgery for various joint and organ surgeries, which have been performed for decades.
As a diagnostic tool, arthroscopic surgery enables the physician to confirm a condition or conduct an examination to gather more information. The orthopedist can proceed with arthroscopic surgery as a corrective treatment, as well. Given the small size of the incisions, the patient has less blood loss and post-surgical trauma, with less scarring and an easier recovery period in general.
Arthroscopic surgery is a same-day procedure. Although “minimally invasive,” we usually do it under general anesthesia to ensure our patients—especially children and teens—are completely comfortable and remain perfectly still during the procedure.
Hip Arthroscopy
For children and teens, hip arthroscopy is usually used to diagnose and treat labral tears (the soft tissue that surrounds the socket), cartilage injuries, snapping hip syndrome, Legg-Calve-Perthes disease (a rare condition), and femoroacetabular impingement (an extra bone grows within the hip joint). It has been proven to be an excellent option for treating pain and inflammation of the hip or to confirm suspected diagnoses to guide an appropriate treatment plan.
Children who engage in sports such as football, weight lifting, activities that involve sprinting, kicking, jumping or hurdling, and dancing are more likely to suffer from labral tears, snapping hip syndrome, and cartilage injuries, but other hip joint conditions are congenital or the result of trauma. If your child has been diagnosed with one of these conditions and non-surgical treatments have not improved their pain, hip arthroscopy will be recommended to address the hip joint injury.
In hip arthroscopy, the physician can:
- repair and clear out the damage to the hip cartilage.
- shave down the bump on the ball joint at the top of the hip bone (the femoral head).
- trim the bony rim of the hip socket (the acetabulum).
Hip joint injury can also stem from hip avulsion fractures due to accidents or sports activities.
Hip Arthroscopy Exam
When your child comes to TPOC, our pediatric orthopedists will conduct a hip arthroscopy exam using small incisions around the hip joint and the special, small instruments designed for this procedure. We inflate the area with sterile fluid so that the orthopedist will be able to view the inside of the hip joint more easily and arrive at a diagnosis. The camera sends the image to a video monitor and the orthopedic surgeon uses those images to guide the instruments. The hip arthroscopy exam includes looking at the cartilage and the labrum. After the exam and hip arthroscopy diagnosis, the orthopedist will perform the necessary surgical procedure.
Hip Arthroscopy Surgery
Our orthopedic surgeons recommend and perform hip arthroscopy for certain problems when non-surgical treatments (rest, physical therapy, anti-inflammatory medications) do not relieve pain or resolve the issue.
During hip arthroscopic surgery, your child will be placed in traction to stabilize the leg. Hip arthroscopic surgery is done to help your child regain range of motion (due to hip impingement), fix torn cartilage, address hip joint deformities, repair soft tissue damage, and remove painful bone spurs. As noted above, the surgeon will use the images the camera sends back on the video monitor to guide the miniature shavers, drills, and burrs used. Your child will go home with dressings over the incisions and those can be removed after a few days.
Recovery
Recovery from hip arthroscopy takes time of course, but because it is less invasive than traditional surgeries, the recovery time is quicker. Post-surgical pain is usually mild. The sutures are usually removed in 7-10 days. There will be some swelling that usually subsides in about a week.
During recovery, your child will use crutches for a couple of weeks to limit weight-bearing on the affected leg, and we may recommend a brace to limit the hip range of motion while the joint heals. We will prescribe several weeks of physical therapy, as well.
Your child may feel immediate improvement right after surgery, but the pain may come and go as the hip joint heals. Expect some temporary tenderness in the hip and knee from the traction used during surgery. Your child may also report feeling like there’s water in the hip or hear gurgling noises, which are from the fluid the surgeon used. No need to worry—this is absorbed by the body in a few days.
While your child will eventually be able to return to their regular activities within three to six months, they may experience pain after fairly rigorous activity; it can take six to twelve months to achieve maximum improvement.
Complications
Arthroscopic surgical procedures carry a relatively low risk of complications compared to major surgeries that require large incisions and hospital stays. As with any other surgery, there is a risk of infection and some joint stiffness, blood clots, and damage to surrounding blood vessels and nerves. Your child may complain of numbness at the site as well. We encourage parents to call our office right away if any complications are suspected or observed.
