Osteoarthritis

Hip joint pain and stiffness accompany osteoarthrosis. Osteophytes are readily visible on radiographic studies. These impinging bony excrescences may contribute to the limited motion present in this disease. While technically possible and appealing, removal of osteophytes per se is not an indication for arthroscopy. These rim protuberances are but the late, bony expression of diffuse joint disease. Articular cartilage involvement that accompanies osteophyte formation is usually full-thickness and exhibits diffuse lesions. McCarthy and Glick have reported a direct correlation between the stage of cartilage loss, especially on the acetabular side, and poor outcome following arthroscopy.3,15

Despite this cautionary note, two situations may warrant surgical consideration. One is a patient who, with a previously normal joint, sustains an avulsion fracture resulting in periarticular ossification that limits motion. The other is a patient with known mild to moderate radiographic signs of arthritis but who was functioning well without symptoms until an injury occurred, producing mechanical dysfunction. Ar-throscopic treatment of a labral tear or chondral loose body can eliminate the buckling, catching, or locking symptoms. The clinician should be judicious in considering surgery in these conditions.

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