Name of the Procedure:

Arthroscopy, Hip, Diagnostic with or without Synovial Biopsy (separate procedure)

Summary

Arthroscopy of the hip is a minimally invasive diagnostic procedure that allows doctors to view the inside of the hip joint through a small camera, called an arthroscope. This procedure may be performed with or without taking a small tissue sample from the synovium, the lining of the joint.

Purpose

The procedure is used to diagnose problems within the hip joint such as labral tears, cartilage damage, or joint inflammation. The goal is to identify the underlying issue causing the patient's symptoms and to determine the best course of treatment.

Indications

• Persistent hip pain not relieved by conservative treatments
• Hip instability or catching sensations
• Suspected labral tears or cartilage damage
• Chronic hip inflammation or suspected infection
• Unexplained hip joint symptoms

Preparation

• Fasting for several hours before the procedure.
• Medication adjustments as advised by the physician.
• Pre-procedure imaging tests like MRI or X-rays to guide the arthroscopy.

Procedure Description

1. The patient is positioned to allow optimal access to the hip joint.
2. General or regional anesthesia is administered to ensure the patient does not feel pain during the procedure.
3. Small incisions are made near the hip area.
4. An arthroscope, equipped with a light and camera, is inserted through one of the incisions.
5. Saline solution may be used to expand the joint space to enhance visibility.
6. The surgeon examines the hip joint for any abnormalities.
7. If necessary, a small biopsy may be taken from the synovium for further analysis.
8. The instruments are removed, and the incisions are closed with sutures.
9. A sterile bandage is applied over the incision sites.

Duration

The procedure typically takes around 30 minutes to 2 hours, depending on the complexity of the case.

Setting

Arthroscopy of the hip is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection at the incision sites
• Bleeding or blood clots
• Nerve or blood vessel damage
• Joint stiffness or swelling
• Adverse reactions to anesthesia
• Rare risk of severe complications requiring further surgical intervention

Benefits

• Minimally invasive with smaller incisions and quicker recovery time
• Precise diagnosis of hip joint issues
• Biopsy can provide valuable information for treatment planning
• Reduced post-operative pain compared to open surgery

Recovery

• Rest and avoid weight-bearing activities for a few days.
• Use of crutches if advised by the physician.
• Ice packs to reduce swelling and pain.
• Physical therapy may be recommended to regain strength and mobility.
• Follow-up appointment to assess recovery and review biopsy results, if taken.
• Most patients return to normal activities within a few weeks.

Alternatives

• Conservative treatments like physical therapy, medication, or injections.
• Open surgical exploration if arthroscopy is contraindicated.
• Imaging tests alone, though less definitive than arthroscopy.
• Each alternative has its own set of risks and benefits which should be discussed with the healthcare provider.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel any pain. After the procedure, mild to moderate discomfort is normal, and pain management will be provided. Ice, rest, and prescribed medications will help manage any pain or swelling. Most patients report a gradual improvement in symptoms and return to daily activities with time and proper care.