Hip arthroscopy: future and outlook
In recent years, various studies have been conducted on hip arthroscopy. The previous short- and medium-term results are very encouraging, so that the hip arthroscopy is used more and more frequently.
Hip arthroscopy has so far only been offered by a few specialized centers. At the same time, the number of patients who specifically ask for arthroscopy of the hip increases. Thus, the demand from patients has steadily increased.
For several years, hip arthroscopy has been established as a standard procedure. The surgical techniques are constantly being improved. Crucial here is a lively exchange of experience among the hip operators. In addition, special instruments for hip arthroscopy have been developed in recent years. This also benefits the patients.
Hip arthroscopy has thus been established in the past as a method for patients in which z. B. a conservative drug therapy is no longer effective, but at the same time the pathological changes are not so pronounced, so that an artificial joint replacement (hip endoprosthesis) comes into question.
For the first time hip arthroscopy with robot performed
The two Bernese hospitals belonging to the Hirslanden Group, Permanence and Salem, use the robot system Mako. According to the announcement, the Mako system is the first image-based robotic arm technology used for hip arthroscopy. For one year, knee prostheses have been used in Bern.
Hirslanden Bern AG wrote in a statement: "The patients treated with mako have, among other things, less postoperative pain and less consumption of analgesics. Particularly in the case of partial dentures, patients benefit from an extremely precise alignment of the prosthesis components with a significant reduction in revision rates early after the operation. "This is why the robotic system has now also been used for the first time in hip arthroscopy.
According to the message, the prosthetic socket in the hip joint is still set by hand. The computer indicates the exact alignment of the prosthesis components, leg length and lever arms. With a CT-based 3D modeling of the bone anatomy, the surgeon can also create a personalized surgical plan and determine implant size and orientation according to individual patient anatomy and adjust it at any time during the hip arthroscopy, the Hirslanden Group continues. The surgeons use the robot technology for milling and setting the acetabulum in the hip joint. If the operator deviates from the planned position, the system automatically stops the milling process.
Healthy after hip arthroscopy in record time!
Hip arthroscopy: A newly discovered surgical access revolutionizes recovery. Almost completely painless after the hip arthroscopy and the first steps only a few hours later - is that possible?
Being able to move freely and painlessly is not always self-evident. You want to do sports, pursue your hobby, play with your children and grandchildren, travel, enjoy your free time undisturbed. But not infrequently make the natural signs of aging, illness or overuse in sports life difficult. If pain determines everyday life, then you have little power for any activities. Of it Peter M. (78 years) can report only too well. "The pain in the hip was almost unbearable! Stair climbing was a single agony. "Also Sabine M. (58 years) suffered unbearable hip pain over 10 years, caused by a pronounced bilateral hip osteoarthritis. Even short footpaths were a painful challenge, which were avoided as far as possible. "Walking, sitting, lying and standing caused additional pain. In addition came blockages and tension of the musculature, thus further pain in the back and the cervical spine. Every movement or sitting cost energy, "says Sabine M.
Many patients, including Sabine M., are reluctant to use artificial hip joints for a long time. Too often one hears about painful and complicated surgeries, incorrect implants or long rehabilitation times. The fear of surgery is often greater than the pain you have to endure every day. Nevertheless, hip arthroscopy is among the 20 most common operations in Germany. Different types of operations are implemented, each with advantages and disadvantages. Around the hip joints run many muscles, nerves and vessels. In most clinics, the surgeons choose a posterior or lateral access to the hip joint. As a result, the muscles must be detached from the bone and then refixed. This leads to a week-long rehabilitation, in which movement such as sitting down or squatting must be absolutely avoided. Otherwise you risk a hip dislocation (bulging of the hip joint).
"About 135 years ago," reports Orthopedist Drs. (NL) Genio Bongaerts of the Arthro Clinic Hamburg, "the hip joint was operated directly from the front". However, this mode of operation was forgotten and a lateral approach was preferred. The hip arthroscopy pioneer, surgeon John Charnley, preferred this form of surgery. Nevertheless, some countries, including France, remained at the more gentle (ventral) access. In this type of surgery, one penetrates between the muscles through to the joint. They are thus completely preserved and this considerably reduces the risk of dislocation. In the original version, there were also disadvantages, since the use of an extension table was obligatory. This was necessary to stretch the tendons and muscles of the leg on the side to be operated to provide enough space for insertion of the prosthesis. Prolonged stretching causes the intraoperative test to be falsified by leg length difference. This can cause the leg with the artificial joint to be a few inches too long or too short. For this reason, the surgical procedure was hardly performed in Germany.