Abstract
The cause of unremitting hip joint pain often remains undiagnosed. In the knee, MRI often accurately detects soft tissue pathology, but there is a less than 5% chance that MRI will show an abnormality such as a labral tear. Because conventional surgery can lead to such complications as avascular necrosis, muscle weakness, trochanteric nonunion, heterotopic bone formation, neurovascular injuries and DVT, diagnostic open arthrotomy is seldom performed. Further, prolonged hospitalisation is costly and commits the patient to an extended rehabilitation program.
Arthroscopic hip surgery, a relatively new but well-established procedure, permits the identification of previously unrecognised disorders and in some pathologies offers definitive treatment. In young selected patients with OA it serves as a temporary palliative procedure.
This presentation is based on the first 50 hip arthroscopies performed by the author. Indications for operation were chronic hip pain without radiologically-discernible cause, the presence of loose bodies following trauma, chondrocalcinosis, labral lesions, chondral injuries, ruptured ligamentum teres, avascular necrosis, early OA, biopsy for suspected RA, and non-specific synovial disease. All patients were in hospital for only a day. Mobilisation was encouraged from day one. Dramatic improvement in previous symptoms was noted postoperatively. In three patients with degenerative changes, pain returned after a mean of 6 months and THR was subsequently performed.
Hip arthroscopy is a minimally invasive diagnostic and treatment technique, especially in young patients presenting with hip pain.
Secretary: Dr H.J.S. Colyn, Editor: Professor M.B.E. Sweet. Correspondence should be addressed to SAOA, Box 47363, Parklands, Johannesburg, 2121, South Africa.
