There are a number of surgical procedures that can help relieve hip pain. Sometimes more than one procedure will be done during the same surgery. Understanding these procedures before surgery can help alleviate stress and confusion.
Hip Surgery: Open or Arthroscopy
No matter what surgical procedure needs to be performed, the surgeon must first access the hip joint. To do this, surgeons use either an open or arthroscopic technique.
- Open surgery, requires a long incision—usually about 7 inches. During surgery, the hip is dislocated (and later returned to position). Open hip surgery allows the surgeon to make repairs to surfaces of the inner hip joint.
- Hip arthroscopy is a minimally invasive approach used to diagnose and treat a wide range of hip problems. In arthroscopy, a surgeon inserts special, small, surgical tools and a video camera through a few small incisions (about the size of a buttonhole) to access the hip joint.
In most cases of elective hip surgery for impingement or pain caused by sports injuries the procedure is performed arthroscopically.
Recovery time will vary depending on the surgery performed and in most cases open surgery will require more time in the hospital and on crutches. A surgeon will decide between open or arthroscopic surgery depending on many factors, such as the procedure being performed, a patient’s medical history, and preference.
Most hip surgeries involve a technique called debridement. A special tool is used to remove and any loose, frayed, or damaged pieces of soft tissue (usually cartilage) in the hip joint. Creating smooth surfaces is thought to reduce hip pain and improve function.
Hip Labrum Repair
The hip labrum is a ring of soft tissue that surrounds the hip socket. A torn hip labrum may not heal on its own. Repair surgery is often recommended to patients who are considered low risk and likely to have good post-surgical results.
During hip labrum repair surgery, a doctor will:
- Reattach the damaged or torn portion of the labrum using small plastic anchors and thread.
- Smooth loose or frayed areas of the labrum.
- Make any additional repairs, such as removing bony abnormalities.
Hip labrum repair surgery can be done arthroscopically or using the open technique.
Hip Labrum Reconstruction
In some cases, the hip labrum may be so damaged that repair surgery cannot be performed. In hip labrum reconstruction surgery, a doctor will:
- Confirm the diagnosis and determine the amount of damage.
- Prepare the graft (soft tissue taken from the patient or a donor) so that its size matches the labrum or portion of labrum being replaced.
- Secure the graft to the remaining portion of the labrum using durable stitching.
Labrum reconstruction can be done through arthroscopic or open surgery.
Surgery to Correct Hip Impingement (Femoral Osteoplasty)
Surgery may be recommended to correct hip impingement and restore range of motion. This surgery is appropriate for many patients who have hip impingement and are considered too young for a total hip replacement. During femoral osteoplasty, a surgeon will:
- Remove excess bone from the femoral neck.
- Assure there is enough room in the joint for free range of motion.
- Repair any labral tears caused by impingement.
This hip surgery may be done via an arthroscopic or open technique.
Surgery to Correct Hip Dysplasia (Periacetabular Osteotomy)
If a person has a severe form or a long history of painful hip dysplasia, a doctor may recommend a surgery to correct it. This surgery, called periacetabular osteotomy, involves:
- Making cuts to the hip socket (acetabulum) so it can be repositioned in the pelvis.
- Placing screws in the bone to stabilize the new position.
- Smoothing out any bony abnormalities that may be causing pain.
During recovery, new bone tissue will grow where cuts were made, securing the socket’s new position. This procedure is done via open surgery.
More than one procedure may be done
A person may have more than one procedure done at a time. For example, a surgeon may perform a femoral osteoplasty for hip impingement and also repair a torn labrum.
Hip replacement surgery
If these surgeries fail to relieve hip pain, if the hip damage is too severe, or if significant hip osteoarthritis is also present, a surgeon may recommend a hip replacement.
See Total Hip Replacement for Hip Arthritis on Arthritis-health.com