DIMITRIOS K. KOSTOPOULOS
Military Doctor Member of the Hellenic Society of Arthroscopy and sports medicine
Member of the International Cartilage Repair Society (ICRS)
42, Theomitoros Str., GR - 173 42
Τel. +30 210 9914094 | Fax +30 210 9914289 | Mob. +30 6974 320060
Hip Arthroscopy: A new minimally invasive approach to hip disorders.
The structure of the hip, is a very well protected joint, with the femoral head contained within the acetabulum, providing a large range of motion and stability to the joint. This protection is enhanced by strong ligaments and the synovial bursa. In addition, solid muscle mass and tendon adhesions, by further increasing the hip ́s protection.
From the first arthroscopy of the knee, by Takagi in 1918, until the beginning of modern arthroscopy with the arthroscope of Watanabe in 1959, the only effort to investigate from the inside the structure of the hip, was conducted by Burman in 1931 in experiments to cadavers. Since then, numerous hip arthroscopy attempts have been performed, so that the year of 1985 to be considered, in effect, the date of commencement.
The technique of arthroscopy, has been improved and has allowed the increase of treatment possibilities, focusing on the labral lesions; the impact of the femur on the acetabulum; the synovitis of the hip; the damages of the cartilage; aseptic necrosis of the femoral head and osteoarthritis or free bodies in the joint; the septic arthritis; the total hip replacement; unspecified hip pain and disorders of childhood and adolescent hip; with the aim of solving the problems, primarily among the young patients, that were intractable up to today, by postponing in the distant future or eliminating the possibility of occurrence of osteoarthritis, requiring total hip arthroplasty.
Among the symptoms that lead the patient to the physician is the persistent pain in the groin -–olive– in the colloquial; with reflection on the anterior surface of the thigh. This pain can come as a result of stress or at rest, with the patient–s inability to bend his/her hip in order to wear his/her shoes. In addition, the patient may face problems with his gait and some difficulties in entering/exiting a car and a pain when standing up and beginning to walk. The hip arthroscopy is a therapeutic and very rarely a diagnostic method, performed by localised or general anesthesia. It is conducted under fluoroscopic control and traction in the affected area, in which we are achieving the restoration of existing lesions by making holes of 3 to 4 cm in diameter.
The postoperative course of treatment allows the patient to get up immediately and make use of bacteria for a short period. The patient is hospitalised for one day and no blood transfusion is required as in most cases of open hip surgery. A rehabilitation programme is following.
As with the arthroscopic knee surgery in the 80s and the shoulder surgery in the 90s, the hip arthroscopy opens up new treatment pathways for Orthopaedic surgeons, who make progress in our country in this new demanding arthroscopic field, providing solutions to patients with a minimal invasive method and a far more rapid recovery when compared to the open hip surgery.