Hip Arthroscopy

Hip injuries are extremely common in sports and recreation and can be due to a specific injury or may develop over time due to repetition. When a hip injury affects athletic performance, arthroscopic intervention may assist in a person’s return to full strength. In fact, there are even many elite athletes who have benefited from hip arthroscopy.

We spoke with Dr. David Gazzaniga, a sports medicine specialist at NOI, to learn more about hip arthroscopy. Dr. Gazzaniga has previously served as the team doctor for the New York Jets and the head orthopedic surgeon for the New York Islanders and Hofstra University.

What is hip arthroscopy?

Dr. Gazzaniga: Hip arthroscopy is very similar to arthroscopic surgery of other joints. A camera is placed through a small incision into the joints to evaluate and treat injuries. However, arthroscopic surgery of the hip is different than in other joints because of how deep the joint is to the surface and it is a more confined joint space because of its architecture as a ball and socket joint.

What conditions can be treated with a hip arthroscopy?

Dr. Gazzaniga: There are a few conditions that do well with arthroscopy of the hip joint. Much of this revolves around a condition called femoroacetabluar impingement. This can occur due to the shape of the joint, sometimes the bones do not fit perfectly together causing the hip bones to rub, or because of a specialized type of activity or both. This condition typically occurs in conjunction with a tear to the acetabulum. The pain associated with this condition is pain in the groin area, although the pain sometimes may be more toward the outside of the hip. Sharp stabbing pain may occur with turning, twisting and squatting, but sometimes it is just a dull ache.

Also, a patient may have some instability in their hip and may benefit from treatment to tighten the capsule of the joint, which can be done arthroscopically as well.

Finally, a small category of people may benefit from arthroscopy to treat problems around the hip joint like muscle tears, similar to a rotator cuff repair.

Despite our best efforts, the surgery has shown to be unsuccessful for those who have arthritis in their hip joint.

Who might be a good candidate for hip arthroscopy?

Dr. Gazzaniga: Good candidates are people with pain and pinching that have a labrum tear with no arthritis. These people obviously tend to be a younger, more athletic group. If the patient has arthritis then there should be a very special circumstance to consider going forward with arthroscopic surgery.

What are the advantages of hip arthroscopic surgery?

Dr. Gazzaniga: There are places around the world that are doing this surgery open for similar problems but the advantage of arthroscopy is to spare soft tissue trauma, which can mean less pain and a faster recovery than open surgery. The other advantage is that in many ways the visualization is better arthroscopically because you can see portions of the hip joint that are very difficult to view during an open procedure.

How long does the procedure take?

Dr. Gazzaniga: A typical arthroscopy to repair a labrum and trim the bone on the rim and the femur takes about 90 minutes.

Typically, how long is the recovery process?

Dr. Gazzaniga: Unfortunately comparing a hip arthroscopy to a knee arthroscopy the process takes much longer to recover. A person can return to sports from a simple knee arthroscopy within a few weeks but from a hip scope it can take 3-6 months.

How long before patients can return to an active lifestyle?

Dr. Gazzaniga: Usually I allow them to attempt jogging at about 3 months and full sports at 5-6 months depending on the sport.