A new type of hip surgery using small, precision tools is helping to get athletes and weekend warriors in their 20s through 40s back on their feet.

Arthroscopic surgery has revolutionized knee and shoulder surgery. The technique is now being applied to the hip joint, although the procedure is new in Canada and doctors are still assessing its effectiveness.

It will take time before hip arthroscopy becomes mainstream, said Dr. Nick Mohtadi.
(CBC)

It may help the thousands of Canadians who are too young to qualify for hip replacement surgery or have problems that aren't considered severe enough for a new hip.

Hip arthroscopy is seldom performed in Canada.

To carry out the procedure, rather than cut open the entire hip, doctors insert precision tools and a camera directly into the hip joint through tiny incisions.

The surgery may be an option for younger people who have developed any arthritis, said Dr. Nizar Mahomed.
(CBC)

"In my own experience, what I've been finding is if it is a simple problem the results are very good," said Dr. Nick Mohtadi, an orthopedic surgeon at the University of Calgary who has performed about 80 of the operations.

Using X-rays as a guide, Mohtadi drills three holes or portals into the socket that holds the hip damage and then uses the camera to assess the damage, such as a tear in the rim in the socket. Precision-guided instruments are used to shave down the joint and repair the tear.

Jury out on effectiveness

Since the hip is a more constrained joint than the shoulder, it is more difficult to get into, Mohtadi said. It will take time and training before the surgery evolves into a more mainstream operation, and there is more research on its effectiveness, he added.

The jury is still out, and it isn't for everyone, said Dr. Nizar Mahomed, head of musculoskeletal health at Toronto Western Hospital.

"I think hip arthroscopy at this point would be for the younger, high demand individual or athlete," said Mahomed.

For patients such as 21-year-old Kelly Pomares of Okotoks, Alta., where the hip is damaged by tears or loose bone chips, there is some evidence that arthroscopic surgery helps.

Pomares has a passion for horseback riding but painful damage to her hips has kept her out of the saddle. A week after her arthroscopic surgery, it is difficult to tell how it will turn out.

"It's been better every day," said Pomares. "My hip is a little sore still, a little stiff, just because I've been on crutches."

So far, only a few doctors in Canada are performing the operation, which is not recognized by provincial health insurance programs. Some jurisdictions lack a fee code, which means doctors need to get special permission every time they do it, said Mahomed.

Over time, it is expected to become an option for an increasing number of Canadians.