Name of the Procedure:

Arthroscopy, hip, surgical; with acetabuloplasty (i.e., treatment of pincer lesion)

Summary

Arthroscopy of the hip with acetabuloplasty is a minimally invasive surgical procedure used to treat a specific type of hip impingement known as a pincer lesion. During the procedure, small incisions are made, and a camera (arthroscope) along with surgical instruments are used to reshape the acetabulum (hip socket) and remove any excess bone causing the impingement.

Purpose

This procedure addresses hip pain and limited range of motion caused by pincer lesions. The goal is to relieve pain, improve hip function, and prevent further joint damage.

Indications

• Hip pain caused by femoroacetabular impingement (FAI)
• Limited hip movement or flexibility
• Persistent symptoms that do not respond to conservative treatments like physical therapy or medication
• Diagnosis of pincer lesion via imaging studies (X-rays, MRI)

Preparation

• Fasting for at least 8 hours prior to the procedure
• Adjusting or stopping certain medications (e.g., blood thinners) as advised by the doctor
• Pre-operative diagnostic tests like X-rays, MRI, or CT scans
• Pre-surgery consultation with the surgical team to discuss the procedure and anesthesia

Procedure Description

1. The patient is given anesthesia (general or regional).
2. Small incisions are made around the hip joint.
3. An arthroscope is inserted to visualize the inside of the hip joint.
4. Specialized instruments are used to trim and reshape the acetabulum, removing the excess bone causing the pincer lesion.
5. The surgical site is irrigated and checked for any remaining fragments.
6. Incisions are closed with sutures or surgical tape.

Duration

Typically takes about 1-2 hours.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon specialized in hip arthroscopy
• Anesthesiologist or nurse anesthetist
• Surgical nurse
• Surgical technician

Risks and Complications

• Infection at the incision sites
• Blood clots
• Nerve or vessel damage
• Hip stiffness or weakness
• Incomplete relief of symptoms

Benefits

• Relief from hip pain
• Improved range of motion and hip function
• Less invasive than open surgery with a faster recovery time
• Prevention of future joint damage

Recovery

• Post-procedure crutches or walker may be needed for initial mobility
• Pain management with prescribed medications
• Physical therapy to strengthen muscles and restore full range of motion
• Recovery typically takes several weeks, with most patients returning to normal activities within 3-6 months
• Follow-up appointments for progress evaluation

Alternatives

• Non-surgical treatments: Physical therapy, anti-inflammatory medications, activity modifications
• Open hip surgery: More invasive, longer recovery, but may be necessary for complex cases

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel any pain. Post-procedure, there may be some discomfort, swelling, and bruising around the hip. Pain management includes medications and ice packs. Early mobility with crutches is encouraged, followed by physical therapy to aid in recovery and return to daily activities.