Hip Post-less Distraction

The hip joint is a ball and socket joint and is surrounded by muscles, ligaments, and tendons. Traditionally, access to the hip joint for surgery was achieved by placing traction to the operative leg and perineal posts (wide-diameter post) in the groin region. This was necessary for the distraction of the joint and introducing surgical instruments to perform the surgery. Perineal posts apply pressure to the groin region and may cause:

• Skin complications
• Pudendal neuropraxia (temporary loss of nerve conduction)
• Damage to surrounding nerves
• Sexual disorders (both men and women)
• Necrosis of the surrounding tissue
• Vaginal tears (women)

Post-less Hip Arthroscopy

Post-less hip arthroscopy is a minimally-invasive surgical technique that does not involve the use of perineal posts. Surgery is performed by arthroscopy. An arthroscope is a small, fiber-optic instrument consisting of a lens, light source, and video camera. The camera projects images of the inside of the joint onto a large monitor, allowing your surgeon to look for any damage, assess the type of injury and repair it.

Indications for Post-less Hip Arthroscopy

Post-less Hip arthroscopy is indicated for one or more of the following hip conditions:

• Torn hip cartilage that causes hip pain and immobility
• Torn labrum (fibrous cartilage ring that lines the acetabular socket)
• Bone spurs or extra bone growths caused by arthritis or an injury
• Inflamed synovium (lining of the joint) if you have inflammatory arthritis (partial synovectomy)
• Fractures or torn ligaments caused by trauma

Preparing for the Surgery

Talk to your doctor about the medicines you are taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia. Do not eat or drink 6-8 hours prior to the surgery. Be prepared for an overnight stay at the hospital and arrange for someone to drive you home the next day.

Post-less Hip Arthroscopy Procedure

The procedure is performed under general anesthesia and involves the following steps:

• You will lie on your back (supine position) on the operating table.
• Your body will be supported by a shape-conforming foam. Bony prominences of your foot may be padded.
• A narrow-padded post is used which may be placed about 10cm away from the perineum. The post is off-center and towards the operative side. This unique positioning achieves hip distraction necessary for the arthroscopic surgery. Non-operative limb positioning is maintained stress-free.
• Internal rotation of the limbs will be performed by your surgeon enabling the placement of the arthroscope in the hip joint.
• Traction techniques are used by your surgeon for safe insertion of the arthroscope.
• The arthroscopic surgery is performed on your hip depending on the type of hip problem.

Advantages of Post-less Hip Arthroscopy

Since no pressure is applied to the perineum, damage to the nerves and the soft tissue is prevented.

Post-operative Rehabilitation

Painkillers will be prescribed to manage pain. Your physical therapist will teach you to use a walker or crutches and may begin with light weight-bearing exercises. Specific exercises will be given to help you recover faster. You should regularly follow-up with your surgeon to ensure a successful outcome. You may return to normal activities after a few months with your surgeon’s approval.

Why Choose Dr. J. Pieter Hommen for Your Hip Arthroscopy?

Dr. J. Pieter Hommen is a fellowship-trained orthopedic surgeon with advanced expertise in minimally invasive hip preservation and hip arthroscopy. His approach is centered on precision, careful patient selection, and restoring long-term hip function—not simply operating for the sake of surgery.

Dr. Hommen treats the full spectrum of intra-articular and peri-articular hip conditions using modern arthroscopic techniques, including femoroacetabular impingement (FAI), labral tears, tendon injuries, and complex sources of deep gluteal and sciatic pain. His experience extends beyond the hip joint itself to surrounding structures such as the gluteal tendons, proximal hamstring origin, piriformis tendon, and peritrochanteric space—areas that are frequently overlooked but often responsible for persistent symptoms.

A key distinction of Dr. Hommen’s philosophy is his commitment to hip preservation. Whenever possible, he emphasizes non-operative treatment and structured rehabilitation. Surgery is recommended only when it is clearly indicated and likely to improve function and quality of life. When arthroscopy is performed, it is done with meticulous attention to anatomic detail to minimize tissue disruption and optimize recovery.

Patients choose Dr. Hommen for his:

• Fellowship training and specialized focus on hip arthroscopy
• Expertise in both joint and extra-articular hip pathology
• Thoughtful, evidence-based decision-making
• Minimally invasive, tissue-sparing surgical techniques
• Clear communication and individualized care plans

Whether treating athletes, active adults, or patients with complex hip pain, Dr. Hommen’s goal is consistent: to relieve pain, restore strength and mobility, and help patients safely return to the activities they enjoy.