Hip arthroscopy is a minimally invasive technique whereby it is possible to look inside the hip joint with the aid of a fibre optic telescope and carry out a number of surgical procedures using this technique. Most people are familiar with knee arthroscopy for the treatment of cartilage and ligament disorders.

Hip arthroscopy is a much less widely performed. This is because it has taken time for the technique and instruments to be developed.

Mr Aslam Mohammed developed instruments, The Pathfinder System to give safe and reproducible access to the hip joint in 1995 (http://www.arthrocaresportsmedicine.com). He has been treating patients with non arthritic pathology of the hip joint since then and has been teaching and training other surgeons in this technique both in the UK and abroad. He is involved with hands on teaching with cadaver workshops.

This procedure is now more widely performed with the availability of training, instruments and recognition of new pathology which is amenable to this procedure. 

The hip is a much deeper joint than the knee and for that reason it is much harder to introduce the arthroscope and instruments into the joint. In order to do this the hip joint has to be distracted by traction to produce a space between the joint surfaces to introduce the instruments into the joint without causing damage to the articular cartilage and the labrum. It is now possible to examine the joint and determine the cause of specific symptoms and in treat their cause.

In general good outcomes are achieved with this operation, recovery is relatively slow over months and is dependent on the underlying pathology/condition being treated and the surgery that is performed.

Loose pieces of cartilage or bone can sometimes form in the joint for a variety of reasons such as; Synovial Chondromatosis, Osteochondral lesions and loose articular cartilage. These can get caught between the joint surfaces leading to pain and cause damage to the articular cartilage. These can be very effectively removed by hip arthroscopy.

This is a strong and important ligament within the hip joint can get torn leading to pain. This commonly occurs in dancers who have done the splits accidentally and are left with a painful hip joint, it can cause clicking with giving way. They also have a restricted range of movement of the hip and are unable to dance. This can be treated at hip arthroscopy by taking away the torn part of the ligament to stop it catching and giving symptoms.

The symptoms are usually reduced range of movement difficulty in bringing the hip up to wards the chest, aching in the groin on sitting at a desk, there can be pain at night, a click may be noticed with acute pain on getting up and walking, also catching and giving way of the hip. Patients experience a reduced level of activity and exercise tolerance to a point of having to give up sports and exercises. In some cases patients have been misdiagnosed with the groin pain and have had operations on the groin performed before the correct diagnosis is made and treated. It is possible at arthroscopy to remove the lesions which causing the symptoms by trimming the abnormal bump off bone from the femoral head/neck junction and from the rim of the acetabulum as well as treating the torn labrum.

-Open Surgical Dislocation of the Hip Joint

In certain situations where there are extensive combined Cam and Pincer femoro acetabular impingement lesions (FAI), it safer and more effective to perform the procedure through and open incision rather than arthroscopically.

Mr Aslam Mohammed utilises the Ganz approach with a trochanteric osteotomy to preserve the blood supply to the femoral head. This gives an excellent view of the pathology and allows the removal of both impingement lesions and repair of the labrum if required.