Hip pain is one of the most common medical complaints among adults of all ages. In older adults, the cause is usually osteoarthritis, and a hip replacement resolves the pain. But what about active younger adults who don’t have osteoarthritis, but still have hip pain that can be severe enough to interfere with their favorite sports? They’re not candidates for hip replacements, but they may benefit from a much less invasive procedure known as hip arthroscopy.
In this video, San Diego Health host Susan Taylor talks about the benefits of this procedure with Brian Rebolledo, MD, an orthopedic surgeon at Scripps Clinic La Jolla who specializes in sports-related injuries of the hip, knee, shoulder, and elbow. Scripps is ranked number one in San Diego and is repeatedly ranked by U.S. News and World Report as among the best in the nation for orthopedic care.
The hip joint consists of a ball and socket. While osteoarthritis is usually the cause of pain on older people, in younger adults it is often due to an abnormally shaped hip joint that causes an impingement. In some cases, there may be extra bone along the femur (thigh bone) that presses against the rim of the socket and injures the soft tissue. Sometimes the socket is too large, or there are impingements elsewhere that affect hip stability and function. Any of these can cause pain and interfere with sports and other activities.
In the past, conventional surgery to dislocate the hip was the only way to access these abnormalities and repair the damage. This procedure required a large incision and a long recovery. Unlike open surgery, hip arthroscopy requires just a few small openings around the hip to access the joint. Using thin instruments designed specifically for the hip and a tiny video camera inserted through the incision, the surgeon repairs the damaged tissue while viewing images of the surgical area on a screen.
“We also want to address why the tissue was actually injured in the first place, and a lot of times it has to do with hip impingement,” explains Dr. Rebolledo. “We can reshape the bone to hopefully prevent this from happening again.”
Hip arthroscopy is one of the fastest-growing segments of sports medicine. The outpatient surgery takes about 90 minutes; most patients go home the same day and return to their usual activities within a few months. Scripps is one of just a few surgical centers on the West Coast to use a new operating table known as a postless distractor to prevent groin numbness, a potential complication of the surgery.
Dr. Rebolledo says the best candidates for hip arthroscopy are typically younger, active patients who have hip pain that is not caused by arthritis and have not been helped by anti-inflammatory medicines and other conservative treatments. A physical examination and imaging tests can determine whether a patient has a hip impingement and could be helped by arthroscopy.
“If you have long-standing hip pain that has been keeping you from what you want to do, that is a telltale sign that something is going on within the hip and you should get it checked out,” says Dr. Rebolledo. “Ignoring these symptoms can allow the tissue to become more degenerative and contribute to severe injuries that are more difficult to treat.”