What is Hip Arthroscopy

Hip arthroscopy is a surgery to examine the inside of the hip joint and repair any damage. You may have this surgery if you have:

• Loose pieces of bone or cartilage that are causing pain.
• An overgrowth of bone that has damaged some soft tissue.
• A tear in the cartilage that lines the rim of the hip socket (labrum).
• Swollen tissue around the hip joint.
• Damage to the hip joint from a tendon repeatedly rubbing across the joint. Tendons are bands of tissue that connect muscles to bones.
• An advanced infection in the hip (septic hip).
• Hip pain that does not go away with other treatments.

Arthroscopic surgery is done using a thin tube that has a light and camera on the end of it (arthroscope). The arthroscope is placed through a small incision, and the camera sends images to a screen in the operating room. The images are used to help perform the surgery.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to blood vessels, nerves, ligaments, or cartilage in the hip.
• A blood clot that forms in the leg and travels to the lung (pulmonary embolism).
• Failure of the surgery to relieve symptoms.
• Hip stiffness.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• Do not drink alcohol unless your health care provider says that you can.
• Starting one month or more before surgery, do not use any products that contain nicotine or tobacco. These include cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• You may have a physical exam and tests, such as an X-ray, CT scan, or MRI.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your hip area will be cleaned with a germ-killing solution (antiseptic).
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the hip area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic). This may be injected into your groin or thigh.
• Your hip bone (pelvis) will be pulled slightly away from your thighbone (femur) socket. This provides more room for surgical instruments.
• Several small incisions will be made in your hip area.
• Your hip joint will be rinsed (flushed) and filled with a germ-free solution (sterile saline). This expands the area to allow your surgeon to see the joint more clearly.
• An arthroscope will be passed through one of your incisions, into your hip joint.
• Other surgical instruments will be passed through the other incisions. Your surgeon will examine and repair your hip as needed.
• The sterile saline will be drained from your hip.
• Your incisions will be closed with adhesive strips or stitches (sutures) and covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You will be given pain medicine as needed.
• You may be given medicine to lower your risk of blood clots.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• Your health care provider will give you instructions about how much body weight you can safely support on your leg (weight-bearing restrictions). You may be given crutches or other devices to help you move around (assistive devices).
• You may be shown how to do physical therapy exercises to help you recover.
• Do not drive until your health care provider approves.

Summary

• Hip arthroscopy is a surgery to examine the inside of the hip joint and repair any damage.
• Before the procedure, follow instructions from your health care provider about eating and drinking.
• Plan to have someone take you home from the hospital or clinic.

Hip Arthroscopy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Soreness.
• Swelling.
• Pain that can be relieved by taking pain medicine.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), staples, skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision areas every day for signs of infection. Check for:
  • Redness.
  • More swelling or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

Activity

• Do not use your hip or leg to support (bear) your body weight until your health care provider says that you can. Follow weight-bearing restrictions as told. Use crutches or other devices to help you move around (assistive devices) as directed.
• Ask your health care provider what activities are safe for you during recovery, and ask what activities you need to avoid.
• If physical therapy was prescribed, do exercises as directed. Doing exercises may help to improve hip movement and flexibility (range of motion).
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

Driving

• Do not drive until your health care provider approves.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Managing pain, stiffness, and swelling

• If directed, put ice on the painful area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) your leg above the level of your heart while you are sitting or lying down. Try putting a few pillows under your leg. This will take some of the pressure off of your hip.

If you are taking blood thinners:

• Talk with your health care provider before you take any medicines that contain aspirin or NSAIDs. These medicines increase your risk for dangerous bleeding.
• Take your medicine exactly as told, at the same time every day.
• Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.
• Wear a medical alert bracelet or carry a card that lists what medicines you take.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay incision or bone healing. If you need help quitting, ask your health care provider.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Have a fever.
• Have severe pain.
• Have redness around an incision.
• Have more swelling.
• Have fluid or blood coming from an incision.
• Notice that an incision feels warm to the touch.
• Notice pus or a bad smell coming from an incision.
• Notice that an incision opens up.
• Develop a rash.

Get help right away if:

• You have difficulty breathing.
• You have shortness of breath.
• You have chest pain.
• You develop pain in your lower leg or at the back of your knee.
• Your leg becomes numb.

Summary

• It is common to have soreness, stiffness, and some pain after this procedure.
• Take over-the-counter and prescription medicines only as told by your health care provider, including pain medicines.
• To help relieve pain and swelling, put ice on your leg for 20 minutes at a time, 2–3 times a day.
• If physical therapy was prescribed, do exercises as directed. Doing exercises may help to improve hip movement and flexibility (range of motion).