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Q&A with Australian Health Practitioners
What hip surgery do I need?
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Hi, I'm a young 22 year old female, with chronic hip pain, can you please tell me what would be the best hip surgery for my 4 hip issues? 1.FAI 2.Tear at the chondro-labral junction 3.Trochanteric bursal effusion 4.Snapping of the iliotibial band Please help me, Thank you -
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Dr Chien-Wen Liew
Orthopaedic Surgeon
Adelaide Orthopaedic HIP, KNEE and SHOULDER Surgeon specialising in Sports Injury and Joint Replacement. View Profile
The first step is to determine exact why you have these four things, at your young age of 22. For general information purposes:
1. FAI stands for femoroacetabular impingement and is caused by a mismatch between the shape of the ball and socket in the hip. There are two main pathologies: Cam - where the femoral head neck junction has an abnormal bump on it; and Pincer, where the acetabulum (Socket) covers too much of the head. Often the labrum is also involved in FAI. After an MRI is performed the planning can begin. Arthroscopic hip surgery is being used more and more for FAI because of the minimally invasive nature of it in comparison to open approaches. The open approach is called a surgical hip dislocation. Depending on what pathology there is, will determine which operation is best. Arthroscopy is a great option in most cases, as recovery is quite quick.
2. A chondrolabral tear often occurs in conjunction with FAI. On its own, a hip arthroscopy is the most suitable. It gives visualisation of about 70-80% of the hip. Most of these lesions are in an area of the hip that is accessible using hip arthroscopy.
3. Surgery is usually not required for trochanter if bursitis. 90% of cases can be managed well with Physiotherapy, anti-inflammatory medications and injections into the bursa with steroid. Surgery results are not highly successful, and should be avoided, or left as a last resort. Depending on why you need surgery, depends on the type of surgery that can be performed. Arthroscopic (key hole) or open approaches can be used. The bursa needs to be removed and the surrounding tissue inspected for muscle tears.
4. Iliotibial band snapping is troublesome and can be related to trochanter if bursitis. Generally no surgery is required.
I hope this helps to answer your question.
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