Hip arthroscopy: when it is and when it is not indicated.

Problems that occur in the hip joint, such as a loose body or labral tear, can be treated arthroscopically or with conventional arthrotomy. Hip arthroscopy can facilitate both comprehensive access to and treatment of an evolving series of conditions that affect the hip joint. Candidates for hip arthroscopy should have reproducible symptoms and physical findings that limit function, and a history of mechanical symptoms. Following total hip replacement, when unexplained symptoms persist despite appropriate conservative treatment combined with a negative workup, arthroscopy can be valuable. Intra-articular third bodies often can be successfully removed arthroscopically. Arthroscopy can be valuable after trauma for evacuation of hematomas and removal of chondral loose bodies, and repair of labral injuries. Contraindications to arthroscopy include advanced osteoarthritis, osteonecrosis with femoral head collapse, an ankylosed joint, significant protrusio or grade III or IV heterotopic bone.