Overview

The film on the left shows a hip joint with a ruptured labrum which otherwise shows a smooth and even cartilage surface. Only at the site of rupture is the cartilage somewhat damaged.

From this, you can easily see how large parts of the joint can be viewed from this portal. Depending on the location of the arthroscope, almost the entire joint can be seen. It is even possible to optically access individual tendons or the bursa of the hip joint.

Both main forms of impingement (cam and pincer) can be treated arthroscopically. It is, however extremely important that the surgeon be very experienced. Even for the most experienced physicians, assessing the perfect measure of correction is often difficult. The osteophytes – the bone spurs along the joint margins must be removed. If too little is taken off, the joint will continue to jam while removing too much will impair the joint guidance resulting in an unstable, painful joint.

In addition, the space within the joint becomes significantly reduced. This increases technical difficulties, for example in cases of labrum reattachment. To give you a feeling for the working space, the handling can be compared to building a ship in a glass bottle with only about four millimeters of maneuvering space. Understandibly, by far not all surgeons have the necessary training to perform such a surgery. As a result, it sadly happens here and there that some corrections are not performed optimally.

In some situation with severe malpositioned hip joints (dysplasia), the deformity cannot be satisfactorily corrected. This condition leads to a situation where there is a continued risk for the joint to prematurely wear out leading to arthritis.

Therefore, hip arthroscopy has two objectives:

  1. To eliminate or minimize the pain and the impairment as much as possible.
  2. To create a situation where the wear and tear, what is inevitable over the course of life, takes place as slowly as possible.

The less a joint is irritated or exposed to mechanical friction, the longer and better it will function!

One example is shown on the right in a video from Swiss television. The professional parkour athlete had surgery 11 years ago and can now exercise again without physical difficulties.

Just as a reminder:
The only thing that really works to prevent arthritis is a BMI under 25, regular exercise and tonedg muscles.