As a nationally-recognized specialist in hip arthroscopy, Dr. Carreira regularly fields questions from patients about hip problems and, more specifically, hip arthroscopy. From time to time, Dr. Carreira will post new questions or updated answers to these hip arthroscopy FAQ.
Key Hip Arthroscopy FAQ (Frequently Asked Questions)
Q: Who is a good candidate for hip arthroscopy?
A: The main reason to perform a hip arthroscopy is to treat hip pain in those patients who have failed nonoperative treatments and who do not have diffuse areas of articular damage (arthritis). It is important to note that hip arthroscopy is a surgical procedure that can be used to treat and correct a variety of hip problems.
The most common injury for which hip arthroscopy is a viable option is a labrum (labral) tear. Other joint problems which can be treated at the time of arthroscopy include ligamentum teres tears (the central ligament of the joint), synovitis (inflammation of the joint lining), loose bodies (free floating pieces of cartilage and/or bone), and femoroacetabular impingement (abnormal bone shape on the acetabular (cup) or femoral (ball) side of the joint.
The typical patient who may benefit from hip arthroscopy is suffering from hip pain and does NOT have a diagnosis of hip arthritis. Arthritis is defined as generalized or diffuse articular cartilage injury of a joint. Hip pain typically occurs in the front and/or the side of the joint, and may also be present in the buttock. Rarely hip joint pain occurs only in the buttock. Patients may experience pain with movement of the hip joint, including flexion, such as when tying shoes or getting into a car, or at rest, such as when sitting or trying to sleep. Patients typically experience increased pain with increased activity, either during the activity itself, or in the day or two following the activity.
The majority of patients, as noted in our MASH Study Group of over 2500 patients, have gradual onset of pain without a history of trauma or injury. Patients generally have “normal” x-rays that do not show any signs of arthritis. On close review of these x-rays however, forms of femoroacetabular impingement (FAI) may exist. An MRI typically is performed to detect labral tears, which are a common cause of chronic pain in the hip joint.
Q: What factors might limit the success of a hip arthroscopy procedure?
A: The main limitation in the success of hip arthroscopy is the presence of arthritis, or articular cartilage damage. If the area of damage is small, a microfracture technique at the time of arthroscopy is oftentimes successful in repairing the damaged cartilage.
If there is diffuse (wider spread) articular cartilage damage, meaning that damage of the articular cartilage is throughout the joint, the best treatment is a joint replacement.
X-rays are the best way to determine the extent of articular cartilage damage.
Q: Where can I learn more about hip arthroscopy?
A: The American Academy of Orthopedic Surgeons (AAOS) has an entire section of its website dedicated to providing detailed information about hip arthroscopy.
Q: What might a hip exam look and feel like?
A: In the video below, Dr. Dominic Carreira explains the process of walks through what a typical hip exam might entail for his patients.
For more videos about hip arthroscopy from Dr. Carreira, please visit his extensive video library on YouTube.