HEALTH MATTERS 4/15: Hip Scopes Can Repair Tears and Reduce Arthritis Risk

By William Rossy, MD

Whether the damage is sudden — the result of a sports injury or accident — or occurs over time due to wear and tear, hip problems can cause considerable pain and limit your physical activities.

Fortunately, if the joint is otherwise healthy with no signs of arthritis, a minimally invasive hip arthroscopy (also known as a hip scope) can help treat the problem and minimize the risk of developing hip arthritis in the future.

If you suffer from hip pain that limits physical activity, talk with your doctor about whether you are a candidate for hip arthroscopy at Penn Medicine Princeton Medical Center.

Labral Tears Common Cause of Hip Pain

A hip labral tear is an injury to the cartilage (labrum) that lines the hip socket where the ball-shaped head of the femur or thigh bone sits.

Labral tears are a common cause of hip pain. Studies indicate that more than half of patients with hip or groin pain have labral tears.

Often, a labral tear occurs from an accident or sports injury or from repetitive motion, such as long-distance running. Labral tears are more common in younger athletes who perform a lot of rotating and twisting motions, such as in ice hockey, ballet, football, golf or soccer.

Additionally, tears can occur over time when an underlying problem with the hip joint, such as hip dysplasia or hip impingement, puts additional strain on the labrum.

Seen more often in women, hip dysplasia occurs when the hip socket is too shallow to support the femoral head. Most people who experience hip dysplasia are born with condition, but many don’t experience symptoms until adulthood.

Hip impingement occurs more often in men and is caused when the ball and socket that create the joint don’t fit together properly.

Left untreated, these conditions can lead to osteoarthritis and ultimately the need for hip replacement.

Symptoms

When the labrum is injured or torn, symptoms can include:

• Hip or groin pain.
• Stiffness or limited range of motion in the hip joint.
• A hip joint that locks or clicks.

Other symptoms, often associated with hip dysplasia or impingement, include:

• Stiffness in the hip, thigh or groin.
• Inability to flex the hip beyond a right angle.
• Instability in the hip.
• Limping.
• Unequal leg lengths.

Hip Arthroscopy Can Shorten Recovery Time

Diagnosing hip pain typically begins with a physical examination and imaging tests, including an MRI. If a labral tear or other underlying condition is found, a hip arthroscopy may be recommended.

During the procedure, an arthroscope — a tiny flexible tube with a camera — is inserted into the hip joint through a small incision. This enables the surgeon to view the joint and surrounding structure and to repair the problem without making a large incision through the skin and other soft tissues.

As the American Academy of Orthopaedic Surgeons notes, this results in less pain for patients, less joint stiffness, and often shortens the time it takes to recover and return to favorite activities.

The surgery is often performed on young athletes who injure their hips playing sports. It can also be used to help older, active adults with chronic hip pain from prior injuries, as long as there is no associated arthritis.

A hip scope can also be used to treat hip impingements and dysplasia, cartilage fragmentation, diseased or inflamed joint lining, and bone spurs.

Recovery time varies depending on the actual condition treated and often includes limited or no weight bearing on the hip for a short period of time as well as physical therapy.

Physical therapy greatly reduces the chance of scar tissue developing and causing mobility problems in the future. Research shows that a course of regimented physical therapy following surgery dramatically improves patient outcomes from hip arthroscopy.

Keep Arthritis at Bay

Hip pain can be debilitating and prevent you from doing what you love — whether that’s playing sports, dancing, or simply taking a walk around the neighborhood.

But you don’t have to suffer. Hip arthroscopy help you return to your regular activities, and it also can help you enjoy them longer by preserving the joint and keeping arthritis at bay.

To find an orthopaedic surgeon affiliated with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org/directory.

William Rossy, MD, is an orthopaedic surgeon and is fellowship trained in sports medicine with specialty training in hip arthroscopy. He is a member of the Medical Staff at Penn Medicine Princeton Health.