Hip Arthroscopy

What this procedure is

Hip arthroscopy is a minimally invasive surgery used to look at and treat problems inside the hip joint. Instead of making one large opening, the surgeon makes a few very small incisions, often called "portals."

During the procedure, the surgeon inserts a tiny camera called an arthroscope. This camera sends live pictures to a video screen, allowing the surgical team to see the inside of your hip in great detail. Small surgical tools are then used through the other tiny openings to perform the necessary repairs.

What it treats or fixes

Your clinician may recommend this procedure if you have hip pain that does not improve with rest or physical therapy. It is often used to fix issues that affect the soft tissues and bone shape within the joint.

• Labral tears: Repairing the labrum, which is a ring of tough cartilage that lines the hip socket.
• Femoroacetabular impingement (FAI): Trimming extra bone on the ball or socket of the hip that causes pinching or limited movement.
• Loose bodies: Removing small pieces of bone or cartilage that have broken off and are floating inside the joint.
• Synovitis: Removing inflamed tissue from the lining of the joint.

How common it is & where it's done

Hip arthroscopy has become a common way for surgeons to treat hip conditions without the need for a long hospital stay. Because the incisions are small, many patients find the recovery process more manageable than traditional "open" surgery.

This procedure is typically done in a hospital or an outpatient surgery center. In most cases, you can expect to go home the same day the procedure is performed. Your care team will monitor you briefly after the surgery before you are cleared to leave.

Recovery: What to Expect

Most patients are able to go home the same day as their hip arthroscopy (a procedure using a tiny camera to look inside the joint). You will likely need to use crutches or a walker for 2 to 6 weeks to keep weight off your hip while it heals. This helps the tissues inside the joint mend properly.

Physical therapy is a key part of your journey. Your clinician may suggest specific exercises to help you regain strength and flexibility. While you will start moving soon after surgery, it usually takes 3 to 6 months to return to full physical activity or sports.

Risks & Possible Complications

Every surgery has some risks, though they are not common. These may include:

• Infection or blood clots.
• Nerve injury, which might cause temporary numbness in the groin or leg area.
• Continued pain if the hip joint had significant damage before surgery.

Your care team will give you clear instructions on what to watch for during your recovery. You should contact your clinician if you notice a high fever, redness around the small incisions, or sudden swelling and pain in your calf.

Outcomes & Long-Term Results

The main goal of this procedure is to reduce your pain and help you move more easily. For many people, the results are very positive, allowing them to return to the activities they love.

Your long-term results often depend on the condition of your hip before surgery. For example, if there is already a lot of arthritis (the wearing down of joint tissue), the procedure may not be as effective as it is for other hip issues. Your clinician will talk with you about what you can expect based on your specific health needs.

Emotional Support & Reassurance

It is completely normal to feel nervous before a procedure. Your surgical team is there to support you and answer any questions you have. They will help you manage your comfort and guide you through each step of the healing process.

Focusing on small, daily goals during physical therapy can help you feel more confident and in control. Remember that recovery is a gradual process, and taking it one day at a time is the best way to reach your long-term goals.

Why doctors recommend it

Clinicians often suggest hip arthroscopy when hip pain does not get better with rest, physical therapy, or medicine. This procedure allows a surgeon to look inside the hip joint using an arthroscope—a small camera—to find and fix the cause of the discomfort.

Common reasons for this surgery include:

• Labral tears: Damage to the labrum, which is the ring of cartilage that helps hold the ball of the hip joint in place.
• FAI (Femoroacetabular Impingement): A condition where extra bone grows on the hip joint, causing the bones to rub together.
• Dysplasia: A condition where the hip socket is too shallow, putting stress on the cartilage.
• Loose bodies: Small pieces of bone or cartilage that have broken off and are floating inside the joint.

Urgent vs planned treatment

Hip arthroscopy is almost always a planned, or elective, procedure. This means you and your care team have time to discuss your options and try other treatments first. It is rarely used for emergency situations.

Your clinician may recommend waiting until you have tried non-surgical steps for several weeks or months. If these steps do not help you return to your normal activities, a planned surgery may be the next step to address the underlying issue.

Goals of treatment

The main goal of this surgery is to reduce hip pain and help you move more easily. By repairing damaged tissue or removing bone spurs (smooth bony growths), the procedure aims to restore the natural function of the joint.

Success often means being able to return to daily activities or sports with less discomfort. In some cases, treating these issues early may help protect the joint from further wear and tear, which might delay the need for more major surgeries in the future.

Who may benefit

Hip arthroscopy is a minimally invasive surgery. This means the surgeon uses a tiny camera, called an arthroscope, to see inside the hip joint through very small incisions. This allows them to diagnose and treat certain hip problems without a large opening.

Your clinician may recommend this procedure if you have hip pain that does not get better with rest or physical therapy. It is commonly used to repair a labral tear, which is damage to the ring of cartilage that lines your hip socket. It can also be used to treat hip impingement, where extra bone growth causes the hip bones to rub together painfully.

Other people who may benefit include those with loose pieces of bone or cartilage floating in the joint, or those with a hip joint infection that needs to be cleaned out.

When it may not be the right option

While hip arthroscopy is helpful for many, it is not always the right choice. Your clinician may suggest a different path if you have severe osteoarthritis. This is a condition where the cartilage in the joint has worn down significantly over time.

If the hip joint is already very stiff or the bones are rubbing directly against each other, a minimally invasive procedure may not provide enough relief. In these situations, a more traditional surgery, like a hip replacement, might be a more effective long-term solution.

Your care team will review your imaging and overall health to ensure your hip structure is a good fit for this specific technique.

Questions to ask your care team

It is important to feel comfortable with your treatment plan. You may want to bring a list of questions to your next appointment to help you make an informed decision.

Consider asking your care team the following:

• What is the main goal of this surgery for my specific hip issue?
• What are the risks and benefits of this procedure compared to non-surgical options?
• How much time will I need to take off from work or school to recover?
• Will I need to use crutches or a brace after the surgery?
• What kind of physical therapy will I need during my recovery?

In the procedure room

When you arrive in the procedure room, the surgical team will help you get into a comfortable position on a special operating table. This table is designed to help the surgeon gently pull on your leg, a process called traction. This creates a small space in your hip joint so the surgeon can see inside and move instruments safely.

Your hip area will be cleaned with a special soap to keep the area sterile and reduce the risk of infection. The rest of your body will be covered with surgical drapes to maintain a clean environment.

High-level steps

The surgeon begins by making two or three small incisions, each about the size of a buttonhole. Through one of these openings, they insert an arthroscope, which is a thin tube with a tiny camera and light on the end. This camera sends live images to a video screen in the room.

• A sterile salt-water fluid is pumped into the joint to expand the space and wash away any cloudy fluid, giving the surgeon a clear view.
• Small surgical tools are inserted through the other incisions to repair torn cartilage, trim bone spurs, or remove loose pieces of tissue.
• Once the repair is finished, the surgeon drains the fluid and closes the small incisions with stitches or medical tape.

Anesthesia and pain control

Your clinician may use general anesthesia, which puts you into a deep sleep so you do not feel or remember the surgery. In other cases, they may use regional anesthesia, such as a spinal block, which numbs you from the waist down while you remain relaxed or lightly asleep.

To help manage pain immediately after the procedure, the surgeon often injects a local numbing medicine into the hip joint. This helps you feel more comfortable when you first wake up in the recovery area.

Monitoring and safety steps

Your safety is the top priority during the procedure. A specialized provider will monitor your heart rate, blood pressure, and oxygen levels every few minutes. This constant check ensures your body is reacting well to the anesthesia and the surgery.

The surgical team also uses safety checklists and "time-outs." These are brief pauses where the team confirms the correct patient, the correct hip, and the specific steps of the plan before starting.

Immediately after the procedure

After the surgery is finished, you will be moved to a recovery room where nurses will stay with you as you slowly wake up from the anesthesia. You may feel some grogginess, a dry throat, or a sensation of pressure in your hip.

It is common for your leg to feel heavy or numb for several hours if numbing medicine was used. Before you are ready to go home, your care team will make sure you can stand or move safely, usually with the help of crutches or a walker to protect your hip while it begins to heal.

Typical procedure length

A hip arthroscopy typically takes between 90 minutes and 2 hours. The exact time depends on the amount of repair work the surgeon needs to do inside the joint. Your surgical team will keep your family or friends updated if the procedure takes a little longer than expected.

Common approaches (open vs minimally invasive)

Hip arthroscopy is known as a minimally invasive procedure. This means it is performed through very small cuts, often described as the size of a buttonhole. A specialized tool called an arthroscope—a small tube with a camera—is inserted through these incisions to let the doctor see inside the hip joint without opening it completely.

In the past, doctors primarily used "open" surgery to treat hip problems. Open surgery requires a much larger incision to access the joint. Because arthroscopy uses smaller incisions, it generally causes less trauma to the muscles and tissues surrounding the hip. This approach often results in less pain, less stiffness, and a faster recovery time compared to open surgery.

Partial vs total

When discussing hip surgery, the terms "partial" and "total" usually refer to joint replacement, but the concept is different for arthroscopy. Hip arthroscopy is a preservation procedure, meaning the goal is to keep your natural joint rather than replace it. During the procedure, the surgeon may repair specific tissues or remove only the damaged parts, such as trimming a torn labrum or shaving down bone spurs.

This is distinct from a "total" hip replacement. In a total replacement, the damaged ball and socket are completely removed and replaced with artificial parts. Arthroscopy is often chosen for younger or more active patients to treat specific injuries and delay the need for a total hip replacement later in life.

Revision or repeat procedures

Hip arthroscopy can effectively treat conditions like labral tears or impingement, but it is not a cure for all hip issues. Specifically, it does not cure arthritis. If the cartilage in the hip is already significantly worn down, arthroscopy may not fully relieve pain, or the relief may be temporary.

If symptoms persist or if the condition progresses over time, your clinician may recommend further treatment. In some cases, this might lead to a discussion about hip replacement surgery. The goal of the initial arthroscopy is often to manage symptoms and improve function for as long as possible before more major surgery is required.

Tests and imaging that may be done

Your healthcare provider will explain the procedure to you and ask you to sign a consent form. To ensure you are healthy enough for the surgery, you may need to have a physical exam.

Your clinician may also order blood tests or other diagnostic tests to check your overall health before the operation.

Medication adjustments

It is important to tell your healthcare provider about all the medicines you take. This includes prescription drugs, over-the-counter medicines, and herbal supplements. You should also mention if you have a history of bleeding disorders.

Specifically, let your team know if you take aspirin, blood-thinning medicines (anticoagulants), or other drugs that affect blood clotting. Your provider may ask you to stop taking these medicines before the procedure. Only stop medicines if your clinician instructs you to do so.

Be sure to tell your healthcare provider if you are sensitive or allergic to:

• Any medicines
• Latex
• Tape
• Anesthetic agents (local and general)

Day-before and day-of instructions

Your healthcare provider will give you specific instructions based on your medical condition. Common preparations include:

• Fasting: Follow any directions you are given for not eating or drinking before the procedure.
• Pregnancy status: If you are pregnant or think you could be, tell your healthcare provider.
• Relaxation: You may be given a sedative before the procedure to help you relax.

General surgical risks

Complications from hip arthroscopy are generally rare, but every surgery carries some level of risk. Your healthcare team takes many precautions to keep you safe during and after the procedure.

Some general risks associated with most surgeries include:

• Infection: Bacteria entering the surgical site.
• Excessive bleeding: Losing more blood than expected during the procedure.
• Blood clots: Clots forming in the leg veins, which can be serious if they travel to the lungs.
• Reaction to anesthesia: Breathing difficulties or allergic reactions to the medicine used to put you to sleep.

Procedure-specific complications

In addition to general risks, there are a few complications specific to working inside the hip joint. To see clearly inside the hip, the surgeon may need to use traction (a gentle pulling force) on your leg. This creates space between the ball and socket of the joint.

Potential risks specific to this procedure include:

• Nerve injury: The traction used during surgery can sometimes stretch nerves, leading to numbness or irritation.
• Tissue damage: There is a small risk of injury to the surrounding blood vessels, nerves, or the structures of the hip joint itself.

How complications are treated

Prevention is the first step in managing risks. Your healthcare provider will review your medical history and current medications to lower the chance of problems like bleeding or drug interactions. Factors like smoking or existing health conditions can affect your risk, so your clinician may give you specific instructions to follow before surgery.

If a complication does occur, your care team is trained to handle it. For example, nerve irritation from traction is often monitored closely during follow-up visits. Your provider will discuss your specific risks and how they are managed based on your personal health profile.

Pain control medicines

Managing discomfort is a key part of your recovery. Your clinician may suggest a combination of different medicines to help you feel comfortable. This often includes over-the-counter options like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. These help reduce swelling and soreness in the hip joint.

In some cases, your clinician might prescribe stronger pain relievers for a short time after surgery. It is important to tell your care team about any allergies you have or other medications you are currently taking to avoid harmful interactions. Your clinician will tailor this plan to your specific health needs.

Antibiotics

To help prevent infection, you will likely receive antibiotics. These are medicines that kill or stop the growth of bacteria. Most patients receive a dose through an IV (a small tube in the vein) just before the procedure begins to ensure the medicine is in your system during surgery.

Your clinician may also prescribe a short course of antibiotic pills for you to take at home. Always follow the instructions provided by your surgical team and report any signs of a reaction, such as a skin rash or unusual itching, right away.

Blood thinners and clot prevention

After hip surgery, there is a small risk of developing blood clots in the legs. To help prevent this, your clinician may prescribe blood thinners (also called anticoagulants). These medicines help keep your blood from clotting too easily while you are less active during your early recovery.

Commonly used options include low-dose aspirin or other specific prescription medications. Along with medicine, your team will likely encourage you to move your ankles and start walking as soon as it is safe. Be sure to discuss your medical history regarding bleeding or previous clots with your clinician so they can choose the safest option for you.

Emergency warning signs

Complications after hip arthroscopy are relatively rare, but they can happen. Possible risks include bleeding, infection, and blood clots in the leg. Your surgical team will provide specific instructions on when to go to the emergency room.

Because blood clots and nerve injury are potential risks, it is important to follow your clinician’s advice closely. Always seek immediate help if you experience a life-threatening emergency.

Call your surgeon or clinic if…

Your healthcare provider will give you a list of signs to watch for during your recovery. You should contact your surgeon or clinic if you experience:

• Fever: A temperature of 100.4°F (38°C) or higher.
• Incision problems: Fluid leaking (drainage) from the incision, or redness and swelling around the area.
• Uncontrolled pain: Severe pain that does not get better after taking your pain medicine.
• Nerve changes: Numbness or tingling in your leg.

Expected vs concerning symptoms

Expected: It is normal to need support while your hip heals. Most people use crutches for 1 to 2 weeks after the procedure. You will also likely start physical therapy to help regain strength and motion.

Concerning: While some discomfort is part of the healing process, pain should generally be manageable with medication. Pain that stays severe despite treatment, or signs of infection like fever and redness, are not expected and require medical attention.

Non-surgical treatments

Before suggesting surgery, your clinician will usually recommend trying other ways to manage hip pain. These treatments focus on reducing inflammation (swelling and irritation) and making the hip joint more stable. The goal is to relieve pain and improve how well you can move without needing an operation.

• Physical therapy: A therapist teaches you special exercises to strengthen the muscles around your hip. This can help take pressure off the joint and improve your range of motion.
• Medications: Your clinician may suggest over-the-counter or prescription medicines to help lower pain and reduce swelling in the joint.
• Injections: Sometimes, medicine is injected directly into the hip joint to provide more targeted relief for inflammation.
• Rest and Activity Changes: Simply changing your daily routine to avoid movements that cause pain can give the hip time to calm down and heal.

Watchful waiting

Watchful waiting is a period where you and your care team monitor your symptoms without starting a new procedure. This approach is often used if your pain is mild or if it only happens during very specific activities. It allows you to see if the hip can recover on its own with basic care.

During this time, you might track which movements cause discomfort and which ones feel okay. If the pain stays the same or improves with rest and minor changes to your lifestyle, you may be able to avoid surgery entirely. This period helps determine if the hip issue is a temporary irritation or a long-term problem that needs more help.

When surgery becomes the best option

Your clinician may suggest hip arthroscopy if non-surgical treatments do not provide enough relief. If you still have significant pain, stiffness, or trouble moving after trying physical therapy and rest for several weeks or months, surgery might be the next step to consider.

This procedure is often recommended when there is specific damage inside the joint that cannot heal on its own. This includes issues like a tear in the labrum (the ring of cartilage that cushions the hip socket) or hip impingement, which is when the bones of the hip do not fit together perfectly and rub against each other.

The decision to move to surgery is usually made when the joint is damaged but still healthy enough that a full hip replacement is not needed. By fixing these issues early through small incisions, your clinician aims to reduce your pain and help you return to your normal activities before the joint damage gets worse.

Hospital services that commonly perform this surgery

Hip arthroscopy is usually performed in hospitals or specialized surgery centers that focus on bone and joint health, also known as orthopedics. Because this is a minimally invasive procedure, it is often done in an outpatient setting. This means many patients are able to return home on the same day as their surgery.

These facilities typically have dedicated operating rooms equipped with an arthroscope. An arthroscope is a small camera that allows the surgeon to see inside the hip joint. The hospital will also have specialized tools designed to repair tissue through very small incisions.

Patient resources and support services

Most hospitals provide several resources to help you through the recovery process. A key service is the physical therapy department. Physical therapists are experts who help you perform specific exercises to regain strength and movement in your hip after the procedure.

Other support services may include:

• Pre-operative education: Classes or booklets that explain how to prepare your home for recovery.
• Pain management teams: Specialists who help coordinate your comfort and medication schedule.
• Nursing support lines: A phone number you can call to ask questions about your incisions or activity levels once you are home.

Questions for choosing where to have surgery

When deciding where to have your procedure, your clinician may provide recommendations based on your specific needs. You may want to use the following checklist to help you choose a facility:

• How often does this hospital or surgery center perform hip arthroscopy?
• Is there a physical therapy program that works closely with the surgeons?
• What is the process for reaching a healthcare provider if I have concerns after surgery?
• Does the facility have the latest technology for minimally invasive joint surgery?

Conditions commonly treated by this procedure

Hip arthroscopy is a minimally invasive surgery used to look inside the hip joint. It may be used to treat several conditions that can cause pain or limit your movement.

• Femoroacetabular impingement (FAI): This occurs when extra bone grows on the ball or socket of the hip, causing the bones to rub together.
• Labral tears: The labrum is a ring of tough tissue (cartilage) that lines the hip socket. If this tissue tears, it can cause pain and a feeling of instability.
• Loose bodies: These are small pieces of bone or cartilage that have broken off and are floating inside the joint space.
• Synovitis: This is a condition where the lining of the hip joint becomes inflamed and swollen.

Your clinician may also use this procedure to address snapping hip syndrome, which happens when a tendon rubs against the hip bone, or to evaluate certain types of hip dysplasia (a shallow hip socket).

Related symptoms people search for

People often consider hip arthroscopy when they experience ongoing discomfort that does not improve with rest or physical therapy. These symptoms can vary depending on the underlying cause.

Common symptoms may include:

• A deep ache or sharp pain in the groin area or the side of the hip.
• A clicking, catching, or locking sensation when you move your leg.
• Stiffness that makes it difficult to perform daily tasks, like putting on socks or getting out of a car.
• A limited range of motion, where the hip feels tight or restricted during movement.

If you are experiencing these issues, your clinician may perform a physical exam and imaging tests to determine the cause of your discomfort and discuss potential treatment options.

Evidence overview

Hip arthroscopy is a minimally invasive surgical procedure. This means it is performed using small incisions rather than large cuts. Medical professionals use this technique to look inside the hip joint to diagnose and treat various conditions. It is frequently used to address problems such as labral tears (damage to the ring of cartilage around the hip socket) and femoroacetabular impingement (FAI), a condition where extra bone growth causes friction in the joint.

Because the procedure uses smaller incisions, it often results in less pain, stiffness, and recovery time compared to open surgery. It is generally considered when non-surgical treatments, such as physical therapy or medication, have not provided enough relief.

Safety notes and individualized care

While hip arthroscopy is a common procedure, all surgeries carry some risks. Your healthcare team will take specific steps to minimize these risks and monitor your safety throughout the process. Potential complications may include:

• Infection or bleeding: Standard surgical risks that are monitored closely.
• Blood clots: Your doctor may prescribe medication or movement plans to prevent clots in the legs.
• Nerve injury: Because traction (a gentle pulling force) is used to open the joint space during surgery, temporary numbness or nerve irritation can occur. Permanent injury is rare.

Your care plan will be tailored to your specific needs. This includes the type of anesthesia used (general or regional) and your recovery plan. Most patients go home the same day but will need to use crutches for 1 to 2 weeks and participate in physical therapy to restore strength and movement.

Sources used

Johns Hopkins Medicine