THE VALUE OF HIP ARTHROSCOPY IN TREATMENT DECISION-MAKING IN PATIENTS WITH CHRONIC HIP PAIN

Tzaveas Alexandros
Interbalkan Medical Centre, Thessaloniki
Aim of the study
To demonstrate the value of hip arthroscopy in patients with chronic pain.
Material and method
A woman of 49 presented with a one-year history of chronic pain in the left hip. Plain radiographs of the hips showed a normal joint space with small subchondral cysts in the acetabulum. MRI supported thinning of the articular cartilage of the acetabulum and a possible tear of the labrum. The patient had previously consulted several orthopaedic surgeons and, as there was no evidence of osteoarthritis, it was decided to follow conservative treatment. It was decided to perform hip arthroscopy.
Results supporting the conclusions
At arthroscopy, grade 2 chondral lesions were found in the anterior part of the acetabulum together with degeneration of the labrum. Grade 3 – 4 chondral lesions were also found over a large area of the weight-bearing surface of the femoral head. As the lesions involved a large area of the articular surfaces, it was decided not to carry out any intervention. The patient had the same symptoms postoperatively and, as osteoarthritis was confirmed, hip arthroplasty was planned.
Conclusions
Hip arthroscopy, beyond its therapeutic possibilities, has a high diagnostic accuracy and makes it easier to decide on more aggressive surgical treatment (joint reconstruction) in doubtful cases in relatively young patients without definite radiographic findings of osteoarthritis.