Category
Threshold Criteria
Hip arthroscopy is a technique which allows for the inspection of the interior of the hip. The instrument used is a type of endoscope which is a tube shaped instrument inserted into a cavity in the body to investigate and treat disorders. It is flexible and equipped with lenses and a light source. It is a technically challenging procedure which should only be carried out in specialist units by teams with specific training in the techniques.
Eligibility
| LLR ICB will fund this procedure if the following criteria is met Femoro-Acetabular Impingement (FAI) · Diagnosis of definite FAI defined by appropriate investigations – x-ray, MRI and CT scans · An orthopaedic surgeon who specialises in young adult hip surgery has made the diagnosis. This should include discussion with a specialist musculoskeletal radiologist. · Severe symptoms typical of FAI with duration of at least 6 months where diagnosis of FAI has been made as above · Failure to respond to all available conservative treatment options including activity modification, pharmacological intervention and specialist physiotherapy · Compromised function which requires urgent treatment within 6-8 months’ time frame, or where failure to treat early is likely to significantly compromise surgical options at a future date. · Treatment with more established surgical procedures is not clinically viable Sepsis of the hip joint Hip arthroscopy is supported in the washout of an infected hip joint in the following patients: · Patients who have not responded to medical management · Patients with underlying disease · Patients who are immunosuppressed Loose bodies Hip arthroscopy is supported for the removal of radiologically proven loose bodies within the hip joint with an associated acute traumatic episode. Arthroscopy is not supported as a diagnostic tool where there is suspicion of loose bodies. Excision/ repair of radiological proven labral tear in the absence of osteoarthritis (OA) or femoro- acetabular impingement syndrome: Hip arthroscopy is supported for the excision of radiological proven labral tears associated with an acute traumatic episode in the absence of OA or FAI syndrome |
| LLR ICB will NOT FUND hip arthroscopy in patients with femoro-acetabular impingement if any of the following apply: · Patient has advanced osteo- arthritic change on preoperative x-ray (Tonnis grade 2 or more) or server cartilage injury (Outerbridge grade III or IV) · Patient has a joint space on plain radiograph of the pelvis that is less than 2mm wide anywhere along the sourcil · Patient is a candidate for hip replacement · Patient with severe hip dysplasia or with a Crowe grading classification of 4 · Patient with generalised joint laxity especially in diseases connected with hypermobility of the joints such as Marfins syndrome and Ehlers-Danlos syndrome · Patient with osteogenesis imperfecta |
| ARP 54 Review Date: 2026 |
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