John Urse, DO, FAOAO, a board-certified orthopedic surgeon in Dayton, Ohio, says performing hip arthroscopy is not a technically demanding task. Getting in and out of the joint without leaving evidence behind is where the surgeon’s skill and the tools at their disposal come into play. In a recent virtual grand round presentation at Kettering Health Dayton (Ohio), he recalled performing his first hip scope in 1991 using knee arthroscopy equipment. At the end of the decade, he attended arthroscopy labs run by the Arthroscopy Association of North America, where he first used longer instrumentation that allowed him to see where he was going and what he was doing. He anticipates surgeons being able to map out procedures in 3D using computer-assisted navigation software similar to the platforms that are currently used in total hip and knee replacement surgery.
Today’s instrumentation and advancing technologies make it possible for surgeons to target and treat the underlying pathology of pain in hips and knees. “Are we affecting the natural history of the joint?” asks Dr. Urse. “We fix what we can and try to ensure the patient doesn’t develop osteoarthritis. Our job is to maintain joint function for as long as possible.”
The tools at their disposal are rapidly evolving and changing the way surgeons approach procedures to repair labral tears, removing loose bodies and treating cartilage problems, synovial abnormality and impingements.
“Improvements in visualization, radiofrequency ablation, instrumentation and fixation options now allow surgeons to perform arthroscopic and minimally invasive techniques more frequently during cases that traditionally required open surgeries,” says orthopedic surgeon Mark Getelman, MD, co-director of the Southern California Orthopedic Institute Sports Medicine Fellowship Program in Van Nuys. “This can lead to smaller incisions, less pain and scarring, improved rehabilitation and better outcomes for patients.”