Hip Arthroscopy

This is a Minimally Invasive Surgical procedure in which an examination and treatment of a joint is performed using an arthroscope. During the arthroscopy, we are able to examine and repair your injured or diseased joint with the help of an optical instrument called an arthroscope. An arthroscope is a thin fiber-optic scope which is about the diameter of a pencil.  It is fitted with a miniature camera and light source. Other tools used are shavers, lasers, and a type of biting tool.

Anatomy of the Hip

The hip joint is one of the most important joints in the human body. It allows one to walk, run, and jump. It bears our body’s weight and the force of the strong muscles of the hip and leg.  

The labrum is a type of firm fibrocartilage that surrounds and covers the rim of the hip socket, securing the tight fit. The labrum can become injured or torn because of a traumatic acute injury, or through a degenerative process of chronic tearing. In addition, the Gluteus Medius/Minimus muscles are key stabilizers of the hip joint and serve very important functions during walking and sporting activities. These 3 key elements of the hip are commonly seen as factors for hip pain .

Procedures

Conditions treated with arthroscopic surgery of the hip include labral tears, bone spurs, Gluteus muscle tears, and debridement of surrounding inflamed joint capsule and synovium tissue.

Anesthesia

General anesthesia is used unless contraindicated.  You will receive certain medications through your IV that make you unconscious and unable to feel pain during your surgical procedure.

Surgery Time

Normal time for a hip arthroscopy is 30-45 minutes and in almost all cases the patient is able to return home the same day.

Hospital Stay

You will be in the hospital or outpatient surgery center approximately 3-5 hours. This is an outpatient procedure and rarely an overnight stay. 

Average Total Recovery Time

Total recovery time is from 1-2 months. You will be up and walking the day of surgery, likely with a walker or crutches for a few days.  Most cases are able to be full weight bearing without walking aids within a 2-3 day time period, allowing for driving, returning to work, and a near normal home life.

Incision

You will have two to four 1inch incisions.  It is not uncommon to have clear blood tinged fluid from the saline used in surgery for a few days after surgery. 

Possible Complications

As with all surgery complications may  include infection, nerve damage, circulatory damage, and an anesthesia risk. However, our experience is that there is a very low risk of complications associated with the minimally invasive procedure, making this as very effective positive operative experience for most patients experiencing pain from the conditions referenced above.

Weight-Bearing

You will be weight-bearing as tolerated and will be provided crutches or a walker for pain control and stability. Most patients no longer need crutches after 2-4 days.

Dressing

After 48-72 hours, you may remove your dressing, shower, clean incision with alcohol, and apply dry bandages. If you have steri-strips under your large bandage, you may remove them in 7 days. 

If you have mesh glued to or sutures on your incision, they will be removed at your 2-week follow up appointment.

Medications

Your prescription after surgery will consist of pain medication, usually either Norco or Percocet.  Phenergan or Zofran may also be given for nausea if needed. You will also receive Robaxin for muscle spasms. You may resume one of your anti-inflammatory medicine (Advil, Mobic, Celebrex, Lodine, Indocin, or Aleve) the day after surgery. Pain medication and anesthesia can cause constipation, so increase the bulk in your diet; and if needed, you can take a laxative. Over-the-counter medications are less likely to cause this problem so the sooner you can get off pain medicine the better you will feel.

Tylenol and Advil or Aleve can be taken together for pain to help decrease the need for narcotics. Two and Two, Twice a day will help reduce pain and narcotic use. (2 Tylenol & 2 Advil/Aleve together twice daily).  If you have a prescription arthritis medication that takes the place of Advil/Aleve.

You may resume your home medications in the morning after surgery.

Sleep

If you have difficulty sleeping, we recommend a hot shower right before bed.  You can also take your muscle relaxer (Robaxin/Methocarbamol) and/or Benadryl to help you sleep.

Icing

Ice your hip every 1-2 hours for 20 to 30 minutes the first few days after surgery. This not only helps swelling, but also helps with pain and may be further of assist for relief for the first 2 – 3 weeks.

Exercises post-operative 

Exercise only if you are instructed to do them by Dr. Bramlett after surgery. If you have had reconstructive surgery Dr. Bramlett only wants you to walk around with crutches and progressively bear weight on your hip.  We also may suggest you can sit on a stationary bike for 15-20 min a day after the first day or two which helps in motion and pain control. No lifting over 10-20 pounds and no deep squatting until after your first post op visit.

The hip will be sore yet stable so getting the soreness out and getting off crutches is the primary agenda.

Most of our patients can expect a full recovery using Dr. Bramlett’s home exercise program with no physical therapy visits required.  We will evaluate your progress at you 2-week follow-up appointment and refer you to a physical therapist at that time if we believe it is necessary.

Post-Op Day 1:

1. Begin abduction exercises. Standing up and holding on to a counter, move your operative leg up to the side and back. Do this slowly 5-30 times, as tolerated three times daily.

1. Holding on to a counter, bend over at the waist, bend the knee of your operative leg to 90 degrees. Abduct your leg away from your body. Do this slowly 5-30 times, as tolerated three times daily.

These simple maneuvers will allow you to recover more quickly and gain confidence in walking and driving .

Driving 

You may drive 2-10 days post-op if you did not have surgery on your right hip. You cannot be on narcotic pain medication to drive. You must be able to press the gas pedal and apply brakes safely. Practice hip flexing in a seated position and stomping your right leg to the floor simulating brake pedal application as this is of course very important.

Post-Op Appointment

Your post-op appointment for suture or staple removal will need to be 2 weeks after surgery.  Please call our office at (205) 783-5900 to make that appointment.

Returning to Work

You should be able to resume desk work and light activity in 3-7 days, and more strenuous activity at work in 2-3 weeks.

We are here to help. If you believe you are suffering from one of these conditions, we would love to deliver a diagnosis, get you treated and get you moving again.