Michael B. Gerhardt, MD - Orthopaedic Surgeon - Hip Specialist
Michael B. Gerhardt, MD - Orthopaedic Surgeon - Hip Specialist: (310) 829-2663
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Hip Arthroscopy

Hip Arthroscopy

Hip arthroscopy, also referred to as keyhole surgery or minimally invasive surgery, is performed through very small incisions to evaluate and treat a variety of hip conditions. Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint. Arthroscopy is a term that comes from two Greek words, arthro-, meaning joint, and -skopein, meaning to examine.

Hip arthroscopy may be indicated for the following reasons:

  • Debridement of loose bodies: Bone chips or torn cartilage debris cause hip pain and decreased range of motion and can be removed with hip arthroscopy
  • Removal of adhesions: Adhesions are areas of built up scar tissue that can limit movement and cause pain
  • Repair of torn labrum: The labrum lines the outer edge of the "socket" or acetabulum to ensure a good fit. Tears can occur in the labrum causing hip pain
  • Removal of bone spurs: Extra bone growth caused by injury or arthritis that damages the ends of the bones cause pain and limited joint mobility
  • Partial Synovectomy: Removal of portions of the inflamed synovium (joint lining) in patients with inflammatory arthritis can help to decrease the patient's pain. However, a complete synovectomy requires an open, larger hip incision
  • Debridement of joint surfaces: Conditions such as arthritis can cause the breakdown of tissue or bone in the joint
  • Repair after Trauma: Repair of fractures or torn ligaments caused by trauma
  • Evaluation and diagnosis: Patients with unexplained pain, swelling, stiffness and instability in the hip that is unresponsive to conservative treatment may undergo hip arthroscopy for evaluation and diagnosis of their condition

Find out more about Hip Arthroscopy with the following link

Hip Arthroscopy Hip Arthroscopy

Pre-Op/Post-Op Instructions

Medication Form Hip Arthroscopy Rehabilitation

Femoroacetabular Impingement

Femoro Acetabular Impingement FAI Femoro Acetabular Impingement FAI

Femoroacetabular impingement (FAI) is a condition where there is too much friction in the hip joint from bony irregularities causing pain and decreased range of hip motion. The femoral head and acetabulum rub against each other creating damage and pain to the hip joint. The damage can occur to the articular cartilage (the smooth white surface of the ball or socket) or the labral tissue (the lining of the edge of the socket) during normal movement of the hip. The articular cartilage or labral tissue can fray or tear after repeated friction. Over time, more cartilage and labrum is lost until eventually the femur bone and acetabulum bone impact on one other. Bone on bone friction is commonly referred to as Osteoarthritis.

FAI impingement generally occurs as two forms: Cam and Pincer.

CAM Impingement: The Cam form of impingement is when the femoral head and neck are not perfectly round, most commonly due to excess bone that has formed. This lack of roundness and excess bone causes abnormal contact between the surfaces.

PINCER Impingement: The Pincer form of impingement is when the socket or acetabulum rim has overgrown and is too deep. It covers too much of the femoral head resulting in the labral cartilage being pinched. The Pincer form of impingement may also be caused when the hip socket is abnormally angled backwards causing abnormal impact between the femoral head and the rim of the acetabulum.

Most diagnoses of FAI include a combination of the Cam and Pincer forms.

Symptoms of FAI

Symptoms of femoroacetabular impingement can include the following:

  • Groin pain associated with hip activity
  • Complaints of pain in the front, side or back of the hip
  • Pain may be described as a dull ache or sharp pain
  • Patients may complain of a locking, clicking, or catching sensation in the hip
  • Pain often occurs to the inner hip or groin area after prolonged sitting or walking
  • Difficulty walking uphill
  • Restricted hip movement
  • Low back pain
  • Pain in the buttocks or outer thigh area

Risk Factors

A risk factor is something that is likely to increase a person’s chance of developing a disease or condition. Risk factors for developing femoroacetabular impingement may include the following:

  • Athletes such as football players, weight lifters, and hockey players
  • Heavy labourers
  • Repetitive hip flexion
  • Congenital hip dislocation
  • Anatomical abnormalities of the femoral head or angle of the hip
  • Legg-Calves-Perthes disease: a form of arthritis in children where blood supply to bone is impaired causing bone breakdown.
  • Trauma to the hip
  • Inflammatory arthritis

Diagnosis

Hip conditions should be evaluated by an Orthopaedic hip surgeon for proper diagnosis and treatment.

  • Medical History
  • Physical Examination
  • Diagnostic studies including X-rays, MRI scans and CT Scan

Treatment Options

Conservative treatment options refer to management of the problem without surgery. Nonsurgical management of FAI will probably not change the underlying abnormal biomechanics of the hip causing the FAI but may offer pain relief and improved mobility.

Conservative treatment measures

  • Rest
  • Activity Modification and Limitations
  • Anti-inflammatory Medications
  • Physical Therapy
  • Injection of steroid and analgesic into the hip joint

Surgical treatment

Hip arthroscopy to repair femoroacetabular impingement is indicated when conservative treatment measures fail to provide relief to the patient. Hip arthroscopy is a surgical procedure in which an arthroscope is inserted into the hip joint to assess and repair damage to the hip.


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