 To access this area of the hip, the same portals that are used to access the inside of the hip joint are used. Traction is not needed for the bursectomy portion of the hip arthroscopy.
Gluteus Medius Repair:
Repair of the Gluteus Medius/Minimus tendon(s) is done in the lateral space, where traction is not needed. In the majority of cases, the procedure is completed arthroscopically, however, the size and/or location of the tear may warrant an open technique to be used. The Tendons are visualized and an anchor(s) is placed into the greater trochanter of the femur while a suture is passed around the tendon. The tendon is then pulled down to its normal anatomic position and tied over the bone. For this procedure, a metal anchor is more commonly used as opposed to a bioabsorbable one. The procedure is very similar to that of a rotator cuff in the shoulder.
Removal of Loose Bodies/Tumors: (include PVNS/Synovial Chondromatosis)
Performing a chondroplasty consists of removing loose fragments of cartilage. This is common in the setting of some arthritis.
The cartilage is taken out of the joint by a motorized shaver or a grasper depending upon the size of the fragments.
Post operative equipment
a. Crutches : The weight bearing status following all hip procedures is 20 lbs foot flat (partial weight bearing). Crutch time is dependant upon the type of surgery, but is usually anywhere from 2-4 weeks. Gluteus medius repairs require 6 weeks of crutches, as does a microfracture procedure.
b. Continuous Passive Motion (CPM) Machine : The CPM machine is used for 4 hours/day for 4 weeks, typically. It is a rental so must be returned. Our office will order the machine and have it delivered to the hospital the day of surgery.
c. Brace : The brace is to be worn for 2 weeks following surgery, mainly to prevent extreme flexion and extension of the hip. It is only to be worn while weight bearing with crutches. Due to the configuration of the brace, it must be worn over clothes. The brace is bought through insurance, ordered by our office and delivered to the hospital the day of surgery.
d. Ice machine : The ice machine is a rental ice colling system that is ordered by the office and delivered to the hospital the day of surgery with the other equipment. It is to be used 4-6 times a day for 20-30 minutes at a time.
Post-Operative Physical Therapy Protocols
Follow Up Visits
- 10-14 days following surgery for suture removal
- 6 weeks from the date of surgery (x-rays will be obtained)
- 3 months from the date of surgery
- 6 months from the date of surgery
- 1 year from the date of surgery (x-rays will be obtained)
- 2 years from the date of surgery (x-rays will be obtained)