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Arthroscopy by an Experienced Gold Coast Hip Surgeon
Dr David Agolley is a hip surgeon on the Gold Coast who performs Arthroscopy for the minimally invasive treatment of hip pathology. Dr Agolley treats many conditions, including femoroacetabular hip impingement (FAI), in athletes that require deep hip flexion such as rugby, AFL, soccer, gymnasts, martial arts, horse riders, triathletes, paddlers, dancers and surfers.
Hip arthroscopy is a procedure where a surgeon uses fibre optic technology and small arthroscopic instruments to access the hip joint to treat a variety of problems via minimally invasive keyhole surgery.
Conditions treated with hip arthroscopy
Dr Agolley has a special interest in young adult hip pain and has undergone extended fellowship training in hip arthroscopy, allowing him to address many problems including:
The acetabular labrum is a fibrocartillagenous extension of the bony rim of the hip socket. It effectively deepens the socket providing a suction seal to the ball and socket articulation of the hip, affording more stability and improved fluid lubrication in the joint.
Tears to the labrum are a common source of pain. The labrum can often be debrided or repaired to improve the pain, however this is not always necessary. It is often more important for the surgeon to identify why the labrum tore, usually due to a shape problem of the hip joint.
Femoroacetabular Impingement (FAI)
Dr Agolley treats femoroacetabular impingement (FAI), a condition that occurs during skeletal development, where after skeletal maturity there remains a shape problem of the hip joint. Either a bony bump on the femoral head and neck junction (also known as a cam lesion) or an excessive bony rim of the acetabular socket (pincer lesion), leads to impingement of bone and labrum as a source of pain. Arthroscopy can address these lesions and help to improve symptoms by trimming the bone back to normal shape and repairing the labrum.
Bony and cartilaginous loose bodies can form in the joint causing pain, catching and clunking. These can be removed arthroscopically.
Arthritis is unfortunately not reversible. However, your GP may recommend you see Dr Agolley about the possibilities of hip arthroscopy where in very limited cases, may help improve your comfort.
Ligamentum Teres Injury
This strong ligament in the hip joint can be damaged, particularly in athletes and young females that are hypermobile with excessive rotation in the hips (typically dancers and gymnasts). Ligamentum teres injuries may also occur following a traumatic injury. Investigations including MRI, may not diagnose the torn ligament. Dr Agolley uses hip arthroscopy to diagnose and address the pain caused by the torn ligamentum teres.
Diagnostic assessment of the painful hip
Despite many advances in imaging, the cause of some pain cannot be diagnosed and therefore be adequately addressed. Arthroscopy can be used by surgeons to look inside the joint to help with the diagnosis.
The procedure and post-operative recovery
Not all patients will require all of the steps listed below. The rehabilitation may vary depending on your specific pathology.
- The procedure is done under a general anaesthetic
- Gentle traction is placed on the operated limb to allow access to the joint
- Two or three keyhole incisions are made by Dr Agolley to allow passage of the arthroscopy instruments in to the hip joint
- The central compartment (acetabulum, labrum, pincer and ligamentum teres) pathology is addressed
- The peripheral compartment (femoral head and cam lesion) pathology is addressed
- Dr Agolley takes x-rays during the procedure to help confirm correct shape restoration
- The joint is taken through a full range of motion to confirm the impingement has been adequately removed
- The keyholes are dressed
The post-operative recovery consists of
- Discharged on the day of, or next day after surgery
- Partial weight bearing through the operated hip immediately with crutches for a period of 2-4 weeks (This may vary depending on what was required during the procedure)
- Follow Dr Agolley's rehabilitation prescription
- After hip arthroscopy, up to 95% of patients return to sport, and up to 85% of patients return to the same level of sport, in well-selected patients.
There may be numbness on the outer side of the thigh or in the inner thigh and groin. This usually resolves quickly, but may persist for a few weeks. Major nerve or blood vessel injury is uncommon. Blood clots in the legs and lungs are also very uncommon.
For more information, see the American Academy or Orthopaedic Surgeons website.
Our Gold Coast practice
Dr Agolley is an orthopaedic surgeon consulting on the Gold Coast at John Flynn Private Hospital and Gold Coast Surgical Private Hospital. He operates at John Flynn, Gold Coast Surgical Private Hospital, Murwillumbah District Hospital and The Tweed District Hospital.
Offering services including knee and hip replacement, upper and lower limb trauma surgery, treatment for sports injuries, and other hip and knee surgery including anterior cruciate ligament (ACL) reconstruction, he is well equipped to help you on the road to recovery.
Contact his office on (07) 5598 0530 and speak to his staff about your road to recovery.