Dr I de Wilde – Orthopedic Surgeon
MBChB( US) MMED (ORTHOP) (UFS)
Dr de Wilde has proven himself to be at the forefront of Hip/Knee and Shoulder Arthroscopies and has performed more than 1500 hip Arthroscopies in his practice.
He is currently busy with his Ph.D. in” The role of hip Arthroscopies in osteoarthritis “.
Pain in the groin is the most common complaint among adults with hip problems. Identifying the location of the hip pain can help narrow the differential diagnoses and direct the history and examination.
Often sports related motions with trauma can tear the labrum by squeezing the femoral head (CAM lesion) and the hip bone(Pincer lesion) Femoro-acetabular Impingement (FAI).
Activities such as Ice Hockey, Horseback riding, Yoga, Rugby, Ballet, Golf, Tennis, Cycling, Deep Squatting (Powerlifting) can cause FAI.
HOW DO I DETERMINE IF A PATIENT NEEDS AN HIP ARTHROSCOPY?
A common test is the impingement sign. The test is done by bending the hip to 90 degrees (flexion), turning the hip inward rotation, and bringing the thigh towards the other hip (adduction).
X-rays( AP, lateral, Dunn and frog views) provide a visual picture of any changes that are out of the ordinary of the entire structure and location of the hip position.
MRI gives a clearer picture of the soft tissues (e.g. labrum, cartilage, tendons, muscles).
A NEW ARTHROSCOPIC APPROACH
I started performing hip arthroscopy surgery in 2005 and used to do the conventional hip arthroscopies with the use of a C-arm. Since 2011, I changed to the “out-inside” technique with much better outcomes.
One of the outstanding benefits of this approach is that it is less costly for the patient, less theatre time, reduces the recovery time of a patient significantly, and is a much more effective,non-invasive technique.
CONCLUSION:
Hip Arthroscopy, as compared to knee and shoulder scope surgery is now made an easy procedure with the new outside technique.
In my experience, the “ out-inside technique”, is user friendly and more orthopedic surgeons can embark onto this method.
