I felt the need to write about this because hip arthroscopy is a fairly new surgery which can produce wonderful results for some people. Because of fast and positive outcomes on high-profile sports heroes, the surgery has been in the news recently. Many orthopedic surgeons may be hot to try it, or see it as a "cure all" for hip pain.
Hip arthroscopy in the news:
Hip Doctor to the Stars
Alex Rodriguez Article
Why so Many Hip Scopes All of a Sudden?
But consider this warning: If you have hip dysplasia, please read on before considering hip arthroscopy. I am not a doctor (ah, the road not taken!), but have already read about too many failed hip arthroscopies performed on people with hip dysplasia. As a hip dysplasia patient myself, I feel obligated to pass on what I've learned.
So many orthopedic surgeons, even those who specialize in hips, don't fully understand hip dysplasia. It is frequently misdiagnosed or overlooked. Arthroscopy may seem like a quick fix for a torn labrum or cyst causing hip pain. However, for those with dysplasia, arthroscopy can further de-stabilize the hip joint, causing increased pain, rapid deterioration in the joint and the need for further surgery.
For those with normal hips, a torn labrum may be caused by sudden trauma (such as a fall) or repetitive injury from sports. For those with dysplasia, a torn labrum is almost always caused or exacerbated by the dysplasia itself. If the tear is fixed but the underlying cause is not, the likelihood of a new tear is great. If the torn labrum is debrided or trimmed away the dysplastic hip, already unstable due to poor mechanics, is further de-stabilized. The likelihood of a repeat tear is extremely high. Once the dysplastic joint is de-stabilized by arthroscopic surgery, arthritis and other problems can set in quickly. Often the post-arthroscopy joint can not be saved by conservative methods such as periacetabular osteotomy (PAO), and a hip replacement is the only remaining option.
If you have been diagnosed with a labral tear and have dysplasia, I urge you to seek the opinion of a doctor who is a dysplasia expert before considering any surgery. If you don't know whether you have dysplasia, ask your doctor to check your x-rays. In particular, if there is no other reason for you to have a labral tear, or if you have other hip symptoms which you may have ignored until now, or if you are in the risk group for dysplasia (first-born female and/or breach birth), DO NOT consider arthroscopy until you know the facts.
For more information on hip dysplasia please check the references listed on this blog, in particular the