Failed Hip Arthroscopy

Hip arthroscopy is a minimally invasive surgical procedure performed to diagnose and treat various hip conditions, including femoroacetabular impingement syndrome and labral tears. While it can be a highly effective procedure for many patients, there are cases where the procedure may not achieve the desired resolution of pain and functional limitations, leading to what might be considered a “failed” hip arthroscopy.

When does hip arthroscopy fail?

Inaccurate Diagnosis

If the initial diagnosis of the hip condition is incorrect or incomplete, the surgical intervention may not address the actual underlying issue, leading to persistent hip symptoms.

Complexity of the Condition

Some hip conditions are more complex than initially anticipated. For instance, severe cases of hip impingement, labral tears, or defects in the hip capsule might require more extensive surgical procedures.

Incomplete Resolution of the Problem

Despite the surgery, the problem might persist due to incomplete removal or repair of damaged tissue, especially in cases of extensive damage or difficulty in accessing certain areas of the hip joint. Most commonly, incomplete smoothing of the bump on the femoral neck can lead to persistent symptoms of hip pain.

Underlying Factors

Patient-related factors such as pre-existing arthritis, joint instability, or poor healing capacity can limit the success of the initial surgery.

Rehabilitation and Recovery

Inadequate postoperative rehabilitation or failure to follow the recommended recovery protocol can impede the success of the procedure.

If my hip is still painful after hip arthroscopy, how long do I have to wait for it to be deemed unsuccessful?

Postoperative pain and recovery timelines can vary among individuals, and the success of hip arthroscopy is often assessed based on the resolution of symptoms and improvements in function. It’s important to note that some discomfort and pain are normal in the initial stages of recovery, and the full benefits of the surgery may take time to manifest. In general, if you are experiencing persistent pain beyond the expected recovery period of 4-6 months, Dr. Nho is available for consultation regarding your prior hip arthroscopy. He will review your medical history, prior surgical procedures, perform a physical examination, and order new X-rays. Advanced imaging, such as an MRI or CT scan may be required. A combination of factors including incomplete resolution of symptoms, evidence of residual impingement or labral tears on imaging, or other unresolved pathology may contribute to the ultimate diagnosis of a failed hip arthroscopy.

What should be done next?

When a hip arthroscopy is deemed unsuccessful, it is essential to reassess the symptoms the patient is experiencing. Understanding if the symptoms are similar to or different from the symptoms the patient experienced prior to their original hip arthroscopy is valuable in characterizing the potential source of hip pain and dysfunction. Further diagnostic tests, injections, imaging studies, and consultations with specialists may be necessary to determine the reason for the failed hip arthroscopy and to explore alternative treatment options. These alternatives might involve additional physical therapy, hip injections, or in some cases, revision hip arthroscopy.