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Hip arthroscopy: State of the Art
Hip arthroscopy has become increasingly common worldwide as advances have been made in the understanding of the pathophysiology of hip injuries as well as technological advances in arthroscopic surgical techniques and instrumentation. In evaluating a patient with hip pain, it is important to obtain a detailed history and to perform a comprehensive physical examination, and then arrange appropriate radiographic and other special tests. Radiography, CT scan and MRI/MR arthrogram are frequently useful in diagnosing hip pathology, but are not all necessary. Intra-articular injection of an anaesthetic with or without steroid should be considered for diagnostic and potentially therapeutic purposes if intra-articular sources of hip pain are part of the differential diagnosis. Conditions which were previously treated with open surgery are now frequently managed with arthroscopic intervention, such as removal of loose bodies, chondral injury, labral injury, femoroacetabular impingement, snapping hip and gluteus medius tears. Complication rates of hip arthroscopy are relatively low (<5%), and the future of hip arthroscopy is bright with foreseeable developments which are likely to include further advances in surgical tools, expansion of indications and probable development of computer-assisted technology and navigation. Further still, there will most likely be advances in biological investigations and treatments such as the usage of serum and joint biomarkers to evaluate chondral injury, and cellular therapies to treat cartilage loss.