Before I answer your question, let me emphasize that I am not a
doctor, and I cannot offer you medical advice. The best person to
provide the information you need is a qualified orthopedic surgeon.
You can find one at the web site of the American Academy of Orthopedic
Surgeons http://www.aaos.org/
Having said that, the Internet is a great source of information on
medical topics, and it can help us talk to doctors with greater ease
and understanding, I think. When I went searching for information on
arthroscopy and hip replacements, I found a wealth of material to
share with you.
As you probably know, an arthroscope is a tiny fiber-optic tube that
can be inserted through a very small incision. It has lenses, a light,
and a camera, so a surgeon can look inside to diagnose what’s wrong
with (in this case) the hip joint. The arthroscope is used along with
other tiny tools to perform minor surgeries inside a joint, such as
scraping out cartilage that may be causing inflammation and pain. A
total hip replacement is another matter. This operation replaces
diseased or damaged bone with plastic or metal replacement parts.
So, I think the short answer to your question is this: the less
invasive arthroscopic procedure is used for many diagnostic and
treatment purposes, but the traditional “open surgery” arthoplasty is
used for total hip replacement.
The Providence Health System in Portland, Oregon gives a good overview
of the definitions and the differences:
“Orthopedic surgery can be roughly put into two categories arthoscopic
(or minimally invasive surgery) and traditional open surgery….
Arthroscopy is a minimally-invasive diagnostic and treatment procedure
most often used to diagnose and treat conditions of a joint (most
often the knee and shoulder; to a lesser extent, the ankle, wrist, and
other joints). Originally arthroscopy was only a diagnostic tool, used
primarily for planning a standard open surgery. Because of the
development of new instruments and advanced surgical techniques, now
more than 30 percent of all orthopedic surgery performed in the United
States is performed with an arthroscope. …Joint replacement is a
surgical procedure to remove and replace an arthritic or damaged joint
with an artificial joint (called prosthesis). This type of surgery is
usually considered after other treatment options have failed to
provide adequate relief from pain or disability. …Currently in the
United States, there are more than 400,000 joint replacement
procedures performed each year - most often involving the hip and
knee, with total joint replacement of the ankle, elbow, shoulder, and
fingers performed less often. …more than 160,000 artificial hip
replacement surgeries are performed annually in the United States.”
You’ll find a lot more detail on causes, treatments, and risks on
their website
http://www.providence.org/oregon/programs_and_services/orthopedics/surgery.htm
If you want to get into the details (and a lot of medical
terminology), you may want to run a Medline search and get into the
research literature. I did, and found several interesting abstracts,
including one published in the German medical journal Unfallchirurg
[2001 Jan;104(1):2-18]. The authors are M. Dienst and D. Kohn, and
their paper is titled (translated into English) “Minimal Invasive
Diagnosis and Therapy of the Diseased or Injured Hip Joint.” The
abstract lists the purposes for which hip arthroscopy is used:
“The following indications have been described for an arthroscopic
procedure of the hip: loose bodies, labral lesions, synovial diseases
such as chondromatosis and pigmented villonodular synovitis,
associated lesions in underlying osteoarthritis, ruptures of the teres
ligament, malorientation of the acetabulum and proximal femur and,
last but not least, "idiopathic" hip pain. The use of hip arthroscopy
in infectious arthritis, avascular necrosis of the femoral head,
Perthes' disease, osteochondrosis dissecans and complications after
total hip replacement is less frequent. Here, in addition to its
diagnostic value, operative arthroscopy of the hip offers removal of
loose bodies, resection of the labrum and ligaments, synovial biopsy,
partial synovectomy, microfracturing, lavage and placement of
intraarticular drainage. The first results of arthroscopic procedures
in the hip are promising. In addition to its diagnostic value and
contribution to the understanding of intraarticular anatomy and
pathology, recent studies have demonstrated the advantages of the
arthroscopic treatment of the hip.”
You can read the complete abstract at
http://intapp.medscape.com/px/medlineapp/getdoc?ord=5&searchid=2&have_local_holdings_file=1&local_journals_only=0&searchstring=hip+replacement+arthroscopy
Additional Links:
Washington University physicians at Barnes-Jewish Hospital in St.
Louis specialize in total joint replacement (arthroplasty). Their
treatments include
 Total joint replacements (hip and knee)
 Joint preserving operations of the hip and knee including
osteotomies and bone grafting
 Hip and knee arthroscopy
http://www.barnesjewish.org/groups/default.asp?NavID=599
The Methodist Health Care System in Houston Texas explains both
arthroscopy and arthroplasty in clear, easy to understand terms at
http://www.methodisthealth.com/Ortho/arthrosc.htm
The Arthritis Foundation has a first-rate animation showing in hip
replacement surgery step-by-step at
http://www.arthritis.org/conditions/surgerycenter/surgerycenterflash/totalhip.html.
You can also print out a brochure on total hip replacement at that
site.
search terms
“hip replacement” arthroscopy
I hope this helps. If you need clarification, please let me know.
eloise-ga |
