Hip Arthroscopy: What Problems Does It Solve?

Hip arthroscopy has provided a new opportunity to visualize, understand, and treat intraarticular hip pathology that was previously only accessible through open techniques. Treatment of labral pathology by open techniques had been described in the literature before the wider use of hip arthroscopy, but it was the advent of hip arthroscopy that brought renewed focus on the association of labral tears with articular cartilage pathology. The relationship of intraarticular cartilage damage and extraarticular deformity of the skeleton is now receiving more attention. Critics of hip arthroscopy opine that it is a technology still looking for a defined role. Nevertheless, the procedure is now used successfully for excision of isolated labral tears, removal of loose bodies and osteochondritis dissecans lesions, and treatment of chondral injury. Like arthroscopy of any joint, hip arthroscopy cannot fully address extraarticular issues such as malalignment, major abnormalities in bone morphology, and advanced arthritic conditions. Hip arthroscopists have demonstrated that the technique can be applied to treatment of both cam and pincer type impingement. The results of this approach are controversial and preliminary. Similarly, arthroscopic procedures such as labral repair, chondral surface treatment, and thermal capsulorraphy have been demonstrated technically possible, but the outcome of these interventions is not proven in the peer review literature.