OVERVIEW
Clinical studies have shown that the hip joint is the most difficult to diagnose, as there are many possible causes associated with pain in the area, while, despite the fact that it is one of the strongest and most stable joints in the body, there are several major and minor causes of injury. The bone anatomy of the hip is quite clear: The ball-shaped head of the femur –the acetabulum- is articulated with the pelvic bone, the depth of which increases thanks to the labrum. It is about a fibrocartilaginous anatomical structure, like a ring, which contributes to the stability and layering of the joint.

In some people with bony abnormalities, the labrum can simply be torn because of its repetitive wear during the normal hip movement (femoroacetabular impingement – FAI). In other cases it may be due to injury (especially during sports activities), loosening of the bursa, dysplasia or degeneration, and can also lead to a damage of the articular cartilage.

WHICH ARE THE SYMPTOMS?
Despite the fact that labral tears may “contribute” to the early development of osteoarthritis, until recently, this particular lesion was not at the core of the concerns, as the role of this specific anatomical structure had been underestimated. Recent studies, however, issue a warning call, underlining that tears in early stages may be asymptomatic, and indicate that they mainly relate to ice hockey, soccer, American football and golf players, as well as ballet dancers.

THE ROLE OF ARTHROSCOPY
Diagnosis is performed through magnetic resonance imaging, but it is confirmed through hip arthroscopy. Depending on the patient, their age, activity level, medical history, and especially in cases where conservative treatment with anti-inflammatory drugs and physiotherapy has failed, surgical treatment is an effective option.

SURGICAL PROCEDURE
During arthroscopy, the surgeon can make a more general assessment of hip joint, through very small incisions and using a camera. The goal is to treat painful symptoms, as well as to prevent arthritis. The purpose is to preserve as much tissue as possible, to remove or smooth out the torn edges, or to repair the tear with absorbable sutures, or to fix it upon the acetabulum with special suture anchors. In addition, if necessary, damages in the adjacent articular cartilage are repaired.

WHAT TO EXPECT AFTER SURGERY
The first physical therapies are performed immediately after surgery. The patient uses crutches for 3-5 weeks, so that the joint is not burdened. Full movement recovery occurs within 9-12 weeks, and athletes are ready to return to action within 12-16 weeks.