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Choosing the Right Patient for Hip Arthroscopy

Posted on: 07/27/2006
Hip problems can be intraarticular (inside the joint) or extraarticular (outside the joint). Arthroscopy can be used to diagnose intraarticular conditions. Arthroscopy is done with the patient under anesthesia. The surgeon inserts a long, thin needle into the joint. A tiny TV camera on the end of the sope shows what's inside the joint.

Changes in the tissues, damage to the bone, or loose pieces of cartilage or bone can be seen. In this review article, surgeons identify who can benefit most from a hip arthroscopy.

First, patients with hip pain that persists despite treatment are considered good candidates. Second, signs and symptoms of an intraarticular problem supports the need for arthroscopy. This can include groin pain or upper thigh pain that goes down the leg. Locking, popping, and/or loss of motion are symptoms of an intraarticular hip problem.

The doctor's diagnosis and decision to do arthroscopy are based on a physical exam, X-rays, CT scan, or MRI. X-rays only show the true cause of hip pain in about 25 percent of the cases. CT is used to look for bone fragments after trauma or injury.

MRI shows the soft tissues and condition of the bone. Injecting a dye into the hip and viewing the joint with special imaging called fluoroscopy is sensitive for labral (cartilage) tears.

When none of these tests leads to a diagnosis, then hip arthroscopy may be the next step. Older patients with severe arhtritis are not likely candidates for hip arthroscopy. Younger patients with fairly recent hip pain and who are not obese have the best results and the fastest recovery time.

Dominic Carreira MD, and Charles A. Bush-Joseph MD. Hip Arthroscopy. In Orthopedics. June 2006. Vol. 29. No. 6. Pp. 517-525.

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