What Happened During Surgery

HAPPY I GET MY STITCHES OUT DAY!  I'm rushing to get ready for my first appointment with Dr. Coleman to hear about my progress and get my stitches out.  I am praying for good news!

Here is a decent example of wear my stitches are on my upper thighs:

Until then... I'll leave you with some interesting information about what went on DURING my surgery.  Happy reading!

Surgical Procedure: What happens during hip arthroscopy?

Before surgery you will be placed under either a general anesthesia or a type of spinal anesthesia. A special operating room table called a traction table will be used.  The hip joint is very tight with little space between the ball and the socket. By applying traction, the surgeon is able to increase this space and allow the arthroscope to be inserted into that space. The end of the arthroscope will be moved about in this space to look throughout the joint. Sterile drapes will be placed to create a sterile environment for the surgeon to work. There is a great deal of equipment that surrounds the operating table including the TV screens, cameras, light sources, and surgical instruments.

The surgeon begins the operation by making two or three small openings into the hip, called portals. These portals are where the arthroscope and surgical instruments are placed inside the hip. Care is taken to protect the nearby nerves and blood vessels. A small metal or plastic tube (or cannula) will be placed through one of the portals to inflate the hip with sterile saline.

The arthroscope is a small metal fiber-optic tube.  It is about 1/4 inch in diameter (slightly smaller than a pencil) and about seven inches in length. The fiber-optics inside the metal tube of the arthroscope allow a bright light and TV camera to be connected to the outer end of the arthroscope. The light shines through the fiber-optic tube and into the hip joint. A TV camera is attached to the lens on the outer end of the arthroscope. The TV camera projects the image from inside the hip joint onto a TV screen next to the surgeon. The surgeon actually watches the TV screen (not the hip) while moving the arthroscope to different places inside the hip joint and bursa.

Over the years since the invention of the arthroscope, many very specialized instruments have been developed to perform different types of surgery using the arthroscope and to see what is going on while the instruments are being used. Today, many surgical procedures that once required large incisions for the surgeon to see and fix the problem can be done arthroscopically  with much smaller incisions. For example, simple removal of a torn labrum or a loose body can be done using two or three small 1/4 inch incisions. More extensive surgical procedures may require larger incisions. Your surgeon may decide during the procedure that the problem requires a more traditional open type operation. If this has been discussed before the operation the surgery may be performed immediately; if it has not been discussed, the arthroscopic procedure will be concluded and another operation at a later date will be planned once your surgeon has discussed with you the details of what was found at the time of the arthroscopy and what more needs to be done.

Once the surgical procedure is complete, the arthroscopic portals and surgical incisions are closed with sutures or surgical staples and covered with surgical strips. A large bandage will be applied to your hip. Hip arthroscopy is usually done on an outpatient basis meaning that patients go home the same day as the surgery.

Crutches are commonly used after hip arthroscopy and the Physical Therapist will show you how to use your crutches on both level ground and also while doing stairs. You will need to follow your surgeon's instructions about how much weight to place on your foot while standing or walking.  How much weight your surgeon would like you to put on your surgical side depends on what your surgeon has done inside your joint. Every surgery is different. Crutches may only be needed for one to two days after simple procedures, but should be used until your surgeon says you can fully weight bear, and until you can walk virtually without a limp.  Even one crutch, used on the opposite side to your injury, can be used to provide some support and allow you to avoid walking with a compensatory gait post-surgically. It is important to avoid doing too much, too quickly.