Hip > Snapping Hip Syndrome > Treatments

    Surgical Release

Preparing for Surgery

The decisions you make and the actions you take before your surgery can be every bit as important as the procedure itself in ensuring a healthy recovery.

   Make sure you have received any equipment you will need when you get home from the hospital. This may include a walker, crutches, ice packs or coolers, or household items to make movement around the house easier. You should receive prescriptions for any of these from your doctor when your surgery is scheduled.

   Understand the potential risks and benefits of the surgery, and ask your surgeon any questions that will help you better understand the procedure. It can also help to talk to someone else who has undergone the same surgery.

   Any physical problems, such as a fever or infection, should be reported to your surgeon, and you should notify your surgeon of any medication you are taking.

   Discontinue the use of any anti–inflammatory medicine, especially aspirin, a week prior to surgery, to prevent excessive bleeding during the procedure.

   To reduce the risk of infection, try to refrain from smoking for at least a week prior to surgery.

   If possible, practice walking with your walker or crutches so you are comfortable using them after surgery.

   Getting a second opinion from a surgeon who is as qualified as the surgeon who gave the initial diagnosis is advisable in any case.

   Make sure the orthopedist performing the surgery is board–certified, which can be determined by calling the American Board of Orthopaedic Surgery at 919-929–7103.

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At most medical centers, you will go to "patient admissions" to check in for your open surgical release. There may be a separate department for overnight inpatient surgery check-in, so be sure to ask your doctor. After you have checked in to the hospital or clinic, you will go to a holding area where the final preparations are made. The paperwork is completed and your hip and thigh area may be shaved (this is not always necessary). You will wear a hospital gown and remove all of your jewelry. You will meet the anesthesiologist or nurse anesthetist (a nurse who has done graduate training to provide anesthesia under the supervision of an anesthesiologist). Then, you will walk or ride on a stretcher to the operating room. Most patients are not sedated until they go into the operating room. Here are some important steps to remember for the day of your surgery:

   You will probably be told not to eat or drink anything after midnight on the night before your surgery. This will reduce the risk of vomiting while you are under general anesthesia.

   Arrange for someone to drive you home when you are released.

   Wear a loose pair of shorts or sweatpants that will fit comfortably over your hip bandage when you leave the hospital.

   Take it easy. Keeping a good frame of mind can help ease any nerves or anxiety about undergoing surgery. Distractions such as reading, watching television, chatting with visitors, or talking on the telephone can also help.

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In a surgical release procedure, the tight muscles, tendons, or ligaments that are causing the snapping sensation in your hip are cut and then sewn back together in a lengthened state. Some of the bone surface over which the tissue bands have rubbing may be reconstructed so you have less friction in your hip joint.

   An arthroscope is inserted into your either the side or top of your hip, depending on which tendon is going to be reconstructed. The arthroscope will also allow your surgeon to see whether or not you have suffered a labral tear or have an irregular femoral head.

   The damaged tendons, ligaments, or muscles are partially released, which means your surgeon cuts part of the soft tissue to release tension.

   The lengthened tissue bands are then sewn together with stitches.

   If your bony ridges in your hip or upper thigh are protruding or have a roughened surface, your surgeon may remove a section of the bone and then smooth the bone surface.

   Incisions are sewn up, a bandage is placed over the incisions, and you are taken to the recovery room.

Recovery Room

After surgery to release tension in your tight ligaments, tendons, or muscles, you usually stay in the recovery room for at least two hours while the anesthetic wears off. Your hip will be bandaged with white gauze pads and may have ice on it. You will be given adequate pain medicine, either orally or through an IV (intravenous) line, as well as instructions for what to do over the next couple of days. Antibiotics and blood thinners (anticoagulants) also may be administered to help avoid infection and blood clots. You should try to move your feet, ankles, and knees while you are in the recovery room to improve circulation. Your temperature, blood pressure, and heartbeat will be monitored by a nurse, who, with the assistance of the doctor, will determine when you are ready to leave the hospital or, if necessary, be admitted for an overnight stay. Most patients leave the same day, but if your surgery was extensive or your overall health is poor, you may have to stay in the hospital for one or two days. Make sure to have someone available to drive you home when you leave, as you will not be able to drive a car.

After surgery to release tension in your tight ligaments, tendons, or muscles, you usually stay in the recovery room for at least two hours while the anesthetic wears off. Your hip will be bandaged with white gauze pads and may have ice on it. You will be given adequate pain medicine, either orally or through an IV (intravenous) line, as well as instructions for what to do over the next couple of days. Antibiotics and blood thinners (anticoagulants) also may be administered to help avoid infection and blood clots. You should try to move your feet, ankles, and knees while you are in the recovery room to improve circulation. Your temperature, blood pressure, and heartbeat will be monitored by a nurse, who, with the assistance of the doctor, will determine when you are ready to leave the hospital or, if necessary, be admitted for an overnight stay. Most patients leave the same day, but if your surgery was extensive or your overall health is poor, you may have to stay in the hospital for one or two days. Make sure to have someone available to drive you home when you leave, as you will not be able to drive a car.

Home Recovery

Following surgical release of your hip tendons, ligaments, or muscles, you will follow a course of rest, anti–inflammatories, physical therapy, and stretching and strengthening exercises. The severity of your symptoms will dictate the course of action your physician recommends. Some patients may need to use crutches or a walker for a few weeks if they have trouble balancing or experience pain when trying to walk after surgery. You should probably try to avoid squatting or walking up hills or stairs for a few weeks since these movements place added stress on your hips. You will most likely begin visiting a physical therapist within a few days after surgery to begin light range of motion exercises. You should not actively stretch or strain your hip muscles until the tissues have had a few weeks to heal.

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With the aid of an aggressive physical therapy program, most active people can heal snapping hip syndrome in three to six weeks. After up to a week of rest, your physical therapist usually helps you learn a light hip stretching routine to loosen up the tight muscles, tendons, and ligaments that were popping or snapping before surgery. Stretching helps you regain a full range of motion in your hip. Your therapist may apply topical anti–inflammatories or heat therapy to your hip before each stretching session. When swelling decreases and you have a full range of motion in your hip, your therapist can help you recondition your hip muscles to prepare them for activities. You usually learn to train your hip muscles for power, using elastic bands and weight resistance, and for endurance, through cardiovascular workouts like cycling, swimming, or running. The most important component of rehabilitation for sufferers of snapping hip syndrome is relative rest. This means modifying your workouts to decrease or avoid the overuse activities that initially caused your pain. For example, instead of riding a bike or running, you could swim or rollerblade. Or, you could reduce the intensity of your workout, by using less resistance when you ride, or by eliminating hills from a running workout.

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Prevention

The best way to prevent recurring snapping hip syndrome is to properly stretch and condition the muscles in your lower back, thigh, and pelvis. You should make the stretching and strengthening routine you learned in physical therapy part of your regular training routine. You may be able to reduce your chances of recurring snapping hip syndrome by avoiding a sudden increase in activities that require repetitive motion, such as cycling or using a stair–climbing machine. Easing into an exercise routine after snapping hip syndrome can help reduce stress on your hip's soft tissues and help you avoid overuse. Weight control is also important. Lightening the load on your hips helps them to function better. You also may consider training with a physical therapist or coach to increase your balance and coordination, which can help better prepare your hip muscles, tendons, and ligaments for the strain of sports and activities.

In the worst cases of snapping hip syndrome, usually when pain and swelling are severe and hip movement is limited, your physician may prescribe surgery. Most people become candidates for surgery if their hip pain is not improved after about six months of non-operative treatment. There are numerous muscles, tendons, and ligaments that may be causing the snappind sensation, such as the gluteus maximus tendon, the ITB ligament, and the iliopsoas tendon. In general, similar surgical procedures are used to release whatever tissue bands are tight and then reconstruct them in a lengthened state.