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Arthroscopic Hip: Boosting Mobility without a Replacement: February 23, 2012

It’s the younger generation’s hip ailment.

“Usually it’s a younger, more active patient, anywhere from 15 to 55,” says Dr. James Bynum, an orthopedic surgeon on Lee Memorial Health System’s medical staff.

Instead of complaints of stiffness or bone on bone rubbing, these patients experience pain on the inside of their hip near the groin.

“It can be either a dull ache, it can be a very sharp knife like pain, it can be popping clicking,” says Dr. Bynum.

Until recently, doctors often had trouble identifying the problem.

“Patients that didn’t have arthritis but had groin pain would be told that maybe it was from a pinched nerve in their back, maybe it was from some type of muscle groin strain, chronic strain or even a gynecologic or urologic problem because we really didn’t understand what else could cause it in an otherwise healthy looking joint on x-ray,” says Dr. Bynum.

In many cases, the culprit was a torn labrum. It’s a form of cartilage that lines the rim of the hip socket and helps stabilize the hip joint.

“That acts kind of like a gasket that can become torn and it may just be frayed a little bit but it doesn’t take a lot of damage to cause a lot of pain,” says Dr. Bynum.

Treating a labral tear has become a hip preserving observation. Surgeons perform hip arthroscopy to work inside the ball and joint by inserting slender tools.

“We can remove what are called ‘loose bodies’ which are small fragments of bone and cartilage that in some people floats around that tight joint and causes a lot of pain and mechanical locking and clicking. Those are easily removed through the scope,” says Dr. Bynum.

Recovery is fast compared to traditional open surgeries that require big incisions. Hip arthroscopy is commonly an outpatient procedure with the patient on crutches anywhere from a week to a month.

“One of the most exciting things about this is that a few short years ago, patients with this problem were either not being diagnosed or they were given rather poor treatment options,” says Dr. Bynum.

While most emphasis is focused on hip replacement, repairing pre-arthritic hips may prevent future problems down the road.