The hip joint is an area that is constantly subjected to stress. But it can be damaged not only with regular heavy exercise, but also with an inactive lifestyle. Until recently, pathological changes in this area could be detected only with the help of X-ray examination. This made it difficult to diagnose many diseases, since ailments were detected at stages at which conservative treatment was no longer effective. This issue has now been resolved. Arthroscopy of the hip joint is a modern method of diagnostics and treatment that allows to detect pathological processes at the earliest stage of their development.
Indications
The method allows you to examine in detail the ligaments, cartilage and bone tissue. If an inflammatory process or foreign elements are detected, it is possible to immediately treat.
The essence of the technique is the introduction insidebody of special equipment - arthroscope. In this case, there is no need to standardly open soft tissues. The doctor inserts the instruments inside through several small incisions.
Indications for hip arthroscopy:
- Presence of complications after previous prosthetics.
- Violation of the integrity of cartilage tissue.
- To detect freely moving intra-articular bodies.
- Diagnosis of the slightest changes in bone tissue.
- Inflammatory process occurring in the synovial membrane.
- Injuries, as a result of which the integrity of the joint tube was broken.
- The presence of chronic diseases that often recur and are not amenable to conservative methods of treatment.
- Osteophytes, adhesions, contractures.
Thus, hip arthroscopy is not only a method of diagnosis, but also a modern method of treatment. If foreign elements are found, the doctor can immediately remove them. In addition, when an inflammatory process is detected, the specialist determines its location and course as accurately as possible, which makes it possible to draw up an effective treatment regimen.
Contraindications
Like any other type of surgery, hip arthroscopy has a number of limitations. The procedure is not performed in the presence of the following diseases and conditions:
- Allergic reactions or individual intolerancemedications used in the study.
- Overweight. With obesity, it is not possible to get to the desired zone.
- Ankylosis of the hip joint. In the presence of this pathology, the cavity does not expand, which makes it impossible to visualize the necessary areas.
- Abnormalities in the structure of joints or bone tissue.
- Blood clotting disorders.
- The general serious condition of the patient, which can be caused not only by diseases of the musculoskeletal system, but also by other ailments.
- Presence of mental disorders in the subject.
In some cases, the list of indications can be expanded during the conversation with the attending physician.
Preparation
Judging by the feedback from patients, hip arthroscopy does not require any specific measures. Preparation for the procedure is standard and includes the following items:
- Therapist's consultation. The task of the doctor is to refer the patient for examination and, based on the diagnostic results, to conclude that the person has concomitant diseases. For this, blood and urine tests are prescribed. If the patient suffers from pathologies of a chronic nature, the examination should be more thorough. In this case, consultation with specialists of a narrow profile is required.
- Conversation with the attending physician immediately before the operation. The specialist needs to provide information on what medications are being taken at the moment. The doctor may recommendtemporarily exclude certain medications. In addition, the specialist must make sure that the general condition of the patient is good. Also, the task of the doctor is the psychological preparation of the subject before the procedure.
- Anesthesiologist's consultation. The type of anesthesia is selected based on the results of the diagnosis and the personal preferences of the patient. Anesthesia can be general, epidural or spinal. It is important to exclude the presence of an allergy to the injected drugs.
If there are no contraindications, permission to perform hip arthroscopy is issued.
Algorithm for carrying out
The duration of the procedure is from 1 to 3 hours. The sequence of actions is as follows:
- The doctor tells the patient in detail what the manipulation is for and what will happen during it.
- The person is laid on their back or he althy side.
- An anesthetic is administered.
- The doctor performs distraction of the joint space so that after the introduction of the instruments it would be possible to carefully examine all the structures. For expansion, the specialist uses special systems.
- An x-ray examination of the hip joint is being carried out, metal markers are previously applied to it. Such actions allow you to determine the places where it is best to make cuts.
- The topography of the nerve trunks and the femoral artery is being assessed. This is necessary in order to prevent damage during diagnosis or treatment.
- If you need to further expand the joint space, the doctor will stretch the limb and inject saline.
- An orthopedic traumatologist or surgeon makes 2-3 small (about 2 cm long) incisions. It is recommended to provide 3 accesses for a complete diagnosis: anterior, posterior and lateral. Doctor inserts instruments.
- The specialist evaluates the state of the articulation, if necessary excised and removes the affected areas and foreign bodies, restores the physiological position of tissues after injuries, removes pathological effusion.
- The final step is suturing and bandaging.
Thus, the doctor can make an accurate diagnosis or perform a full surgical treatment without providing open access.
Rehabilitation period
In most cases, patients recover very quickly. A few days later, an extract from the hospital is carried out. According to reviews, hip arthroscopy is well tolerated by most patients. They soon begin their daily duties.
The length of stay in the hospital increases with the development of any complications. In this case, the patient is discharged on average after 20-30 days.
In order to return to your usual way of life as soon as possible, you must follow the following rules:
- After arthroscopy, complete the full course of antibiotics prescribed by your doctor.
- The first 2 days shows complete rest.
- Researched and/orthe operated joint after arthroplasty is securely fixed. It is forbidden to perform physical activity that can disrupt it.
- The patient must wear elastic bandages and compression stockings for the first 5 days.
- It is forbidden to take hot baths and stay in direct sunlight for 2 weeks after the operation.
The rehabilitation period after hip arthroscopy is very short. This is one of the advantages of the method. Most patients return to normal activities within a few days. Within a few weeks, the wounds heal, and subtle scars remain in their place.
Possible Complications
As a rule, there are no negative consequences after the procedure. However, there remains a small risk of developing the following pathological conditions:
- Acute synovitis.
- Infectious diseases.
- Injury to the joint after insertion of surgical instruments.
- Hemarthrosis.
- Adhesion and scarring.
- Nerve damage.
- Changes in the degree of mobility of the joint that was operated on.
The doctor informs the patient in advance about the possible risks, after which the latter makes the final decision regarding the procedure.
Cost
Hip arthroscopy is a very expensive operation. Its price depends on the chosen institution. In order to avoid the development of negative consequences, it is recommended to heed the advice of a doctor regardingclinics.
In Moscow, arthroscopy of the hip joint costs from 7 thousand rubles. up to 84 thousand rubles. This variation is explained by the level of specialists and the medical institution itself. The lowest cost of arthroscopy of the hip joint was fixed at the Central Clinical Hospital "RAS", the highest - at "K + 31". In the clinic "Miracle Doctor" the operation is performed for 13 thousand rubles, in the "Medlux" - for 30 thousand rubles.
The price range is enormous. In this regard, it is necessary to first find out the cost of the procedure at the registry of the selected institution.
Reviews
According to the opinions of doctors and their patients, arthroscopy is a modern method that allows you to identify and cure the disease at an early stage of its development. With its help, many people managed to avoid standard surgery.
Judging by the reviews, the rehabilitation period is easy and fast. Most people return to their normal lifestyle within a few days.
In closing
Arthroscopy of the hip joint is a modern method for the diagnosis and treatment of many diseases of the musculoskeletal system. Its advantage is that it can be used to detect pathologies at an early stage of their development. In addition, after arthroscopy, the most effective treatment regimen is drawn up.
