Introduction.
1. How is hip arthroscopy performed roughly? Is the trauma relatively minor?
Patients are placed under general anesthesia, in supine or lateral position, and usually require traction. Most patients have three 1-50px incisions, with the possibility of 1-2 additional 25px incisions if a glenoid labral repair is required.
Hip arthroscopy performed by a professional and skilled hip arthroscopist is much less traumatic than traditional open surgery, with less pain and faster recovery.
2.What is the development of hip arthroscopy in Europe, America and other developed countries in the field of hip arthroscopy?
At present, hip arthroscopy in Europe and America is a new growth point in the field of arthroscopy, but there are slight differences between the two, relatively speaking, the United States is more radical, not only for the relevant intra-articular capsule operations, and at the same time extended to the external hip capsule. Europe is relatively conservative, focusing mainly on the intracapsular aspect of the joint.
Indications.
1.What are the suitable conditions for hip arthroscopy?
Checking books, literature and the internet, you will find that it seems to be used in a wide range, but according to my personal understanding of this field, the hip arthroscopic surgery with definite efficacy at present are: hip free body, glenoid labral injury, some types of hip impingement syndrome. Once combined with osteoarthritis and progressive hip dysplasia, the prognosis is often poor and requires a very experienced surgeon specializing in hip arthroscopy.
For synovial lesions, septic arthritis can be used as a diagnosis and treatment, but the efficacy depends on the specific case.
For osteoarthritis, cartilage damage and other diseases arthroscopy can relieve short-term symptoms, long-term efficacy to be further reported.
2, hip pain for many years, examination found a torn labrum with free body, can hip arthroscopy be done?
Most of them can be operated by hip arthroscopy, but for multiple free bodies, hip arthroscopy has a dead space that is difficult to reach and cannot guarantee complete removal.
3, hip dysplasia, hip arthritis, etc., can hip arthroscopy be done?
If it is simple hip dysplasia and/or hip arthritis, I personally do not recommend hip arthroscopy because the long-term efficacy is not clear. Of course more experienced doctors may have a different opinion.
4. Is there any age requirement for hip arthroscopy?
Age is not a contraindication.
Examination.
1.What examinations are required before hip arthroscopy?
Routine preoperative examination. If hip impingement syndrome is considered, special postural X-rays should be done accordingly.
2.Do these examinations vary greatly from hospital to hospital? Can patients be examined in advance at the local hospital?
No, it is not recommended to check at local hospitals. Special postural examinations require the cooperation of experienced doctors and radiologists to clarify the areas to be treated for surgery, and the MRI and CT examinations are of different grades, so the examinations at local hospitals can only be used as reference.
A 50,000 domestic car and a 250,000 imported car cannot be compared, and the same is true for hospital equipment. The clarity of different X-ray machines, MRI and CT is different, which is one of the reasons why most of the higher level hospitals do not recognize the imaging information of the lower level hospitals.
Effectiveness.
1. How effective is hip arthroscopy?
Under the treatment of experienced hip surgeons, after proper selection of surgical indications and adequate communication with patients to inform them of the problems that can and cannot be solved by surgery, more than 90% of patients’ clinical scores are significantly improved and more than 90% of patients are satisfied with the surgical results.
2.What are the advantages and disadvantages of hip arthroscopic surgery compared with previous surgical methods?
The advantages are less trauma, faster recovery, and less chance of postoperative femoral head necrosis than dislocation surgery.
Personally, I think the disadvantages of hip arthroscopy cannot be considered strictly disadvantageous, and most patients are satisfied after proper selection of surgical indications and good communication with them. As you can see from this description, the disadvantage is that hip arthroscopy does not solve all the problems, but no surgery can solve all the problems, so I would say it is not a disadvantage.
The other is that hip arthroscopy must be done by the right surgeon. Not every arthroscopist can do hip arthroscopy, and the same procedure may not be a problem for a skilled surgeon, but it is a problem for an unskilled surgeon.
Are there any after-effects after hip arthroscopy?
In addition to the usual complications of surgery, complications unique to hip arthroscopy are.
(1) Nerve palsy (lateral femoral cutaneous nerve, sciatic nerve, perineal nerve, etc.)
(2) damage to cartilage and structures within the hip joint
(3) joint instability
(4) Vascular injury
(5) Infiltration of perfusate into the posterior abdominal cavity, pelvis or thigh causing fascial compartment syndrome
Postoperative rehabilitation
Is postoperative rehabilitation necessary? How long does it usually take?
Most postoperative hip arthroscopy patients do not require special rehabilitation exercises.
For patients who have undergone glenoid labrum repair and hip arthroplasty, they should gradually bear weight to avoid falls.