29914 Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)

Name of the Procedure:

Arthroscopy, Hip, Surgical; with Femoroplasty (ie, Treatment of Cam Lesion)

Summary

Arthroscopy of the hip with femoroplasty is a minimally invasive surgical procedure where a small camera (arthroscope) and specialized instruments are used to correct abnormalities in the hip joint, specifically treating a bony growth (cam lesion) on the femur.

Purpose

This procedure addresses femoroacetabular impingement (FAI), a condition where abnormal bone growth causes joint damage and pain. The goal is to reshape the femoral head to restore normal movement, reduce pain, and prevent further joint damage.

Indications

• Persistent hip pain or discomfort despite conservative treatments
• Restricted hip movement
• Diagnosed cam lesion through imaging (MRI, X-ray)
• Individuals experiencing symptoms of FAI such as groin pain, stiffness, and limited range of motion in the hip

Preparation

• Pre-procedure fasting (usually after midnight before the day of surgery)
• Adjustments or temporary discontinuation of certain medications as directed by the physician
• Diagnostic imaging and preoperative assessment to confirm the diagnosis and plan the surgery

Procedure Description

1. The patient is placed under general anesthesia.
2. Small incisions are made near the hip joint.
3. An arthroscope is inserted to visualize the joint interior.
4. Specialized instruments are used to trim and reshape the cam lesion on the femoral head.
5. Any damaged tissue or cartilage is repaired or removed.
6. The instruments and arthroscope are removed, and incisions are closed with sutures.
7. The area is dressed, and postoperative care begins.

Duration

Typically takes between 1 to 2 hours.

Setting

Performed in a hospital operating room or outpatient surgical center.

Personnel

• Orthopedic surgeon specializing in hip arthroscopy
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection
• Blood clots
• Nerve or blood vessel damage
• Joint stiffness or instability
• Incomplete relief of symptoms
• Rarely, a need for further surgery

Benefits

• Reduced hip pain
• Enhanced mobility and range of motion
• Potential to prevent further hip joint damage and delay or eliminate the need for hip replacement surgery
• Many patients report improvement within a few weeks to months post-procedure

Recovery

• Post-operative care includes pain management and physical therapy.
• Patients may need crutches for a few weeks.
• Avoid heavy lifting and high-impact activities for several weeks.
• Typical recovery time ranges from a few weeks to several months, with physical therapy playing a crucial role.

Alternatives

• Conservative treatments like physical therapy, anti-inflammatory medications, and activity modification
• Open surgery if arthroscopy is not suitable
• Pros and cons include less invasive nature of arthroscopy versus potential faster recovery with conservative treatments but possibly less efficacy

Patient Experience

• During the surgery, the patient is under anesthesia and feels no pain.
• Postoperative pain is manageable with medication and usually subsides over a few days.
• Physical therapy may start shortly after the procedure to promote healing and restore mobility.
• Patients are encouraged to follow all postoperative care instructions to ensure the best recovery outcome.