Hip Arthroscopy

Hip arthroscopy is a minimally invasive surgical technique performed under anesthesia during a short hospital stay. Through several very small incisions, a camera’s optics are introduced into the hip along with instruments. The diagnosis of coxopathy is confirmed and specified (labrum, cartilage, round ligament, synovium, etc.). Hip arthroscopy also allows for the treatment of certain pathologies, particularly in athletes and young individuals.

Principles of Arthroscopy

The hip, being a deep joint surrounded by powerful muscles, was long difficult to assess with precise imaging and to explore surgically. Hip arthroscopy eventually developed thanks to specific optics angled at 70°, combined with dedicated long instrumentation. The major advantage of hip arthroscopy lies in the absence of a large scar but especially in the ability to directly observe the joint in all its compartments, including in depth (central hip). In the 2000s, the discovery of femoroacetabular impingement opened a field of understanding and treatment of hip lesions in young patients and athletes. Currently, hip arthroscopy is the reference technique in the diagnosis of the impingement, but especially in its treatment and in the prevention of coxarthrosis.

Clinical Results

Depending on the procedures and situations, hip arthroscopy has its place in complement to other medical and surgical techniques. The early treatment of a labral tear, a conflict due to cam effect or pincer effect, the removal of chondromas or foreign bodies, certain cartilage lesions, villonodular synovitis… these situations are the best indications for arthroscopy. The outcome is generally excellent in young subjects without cartilage lesions, while it is less favorable in subjects over 40 years of age and when coxarthrosis is present.

There are some situations where hip arthroscopy is not advantageous and may be formally contraindicated: severe hip dysplasia (insufficient coverage), coxa valga, advanced coxarthrosis, rapidly destructive coxarthrosis (RDC), stiff hip…

Finally, hip arthroscopy can provide crucial insights and sometimes excellent results on a problematic hip prosthesis.

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