Hip treatment
Hip arthroscopy is keyhole surgery for a joint that does not give up its space easily. Where the knee is shallow and accessible, the hip is a ball buried in a deep socket beneath thick muscle — so the operation works through a gap of a few millimetres, created by gently pulling on the leg. Within that gap a great deal is possible: a torn labrum reattached, a pinching bone reshaped, a joint restored to gliding rather than catching. It belongs to a family of operations known as hip preservation — surgery whose whole purpose is to keep your own joint rather than replace it. What is not possible is making a worn-out hip young again, and this page is as clear about that as about the rest.
Two or three keyholes are made over the side of the hip. Through one, an arthroscope lights the joint and projects it magnified onto a screen; through the others, instruments trim, reshape, anchor and stitch. Because the ball sits so snugly in the socket, the leg is placed in gentle traction to open a few millimetres of working space, and X-ray guidance confirms where the instruments sit. As hip preservation surgery, the aim throughout is to leave the joint better able to work rather than to remove and replace it. The muscles are parted rather than cut, which is why walking begins the same day — though full recovery answers to the tissue that was repaired inside, not to the size of the skin incisions.
Recovery after hip arthroscopy — the first nine months
Timings describe typical recoveries — what was repaired inside decides your own, and our specialist will set that out before you commit.
Most people arrive with one question louder than the rest. Tap yours — the straight answer is one scroll away.
The answer divides along a clean line, and it is worth knowing which side you are on before anything is booked. Mechanical problems in a hip whose cartilage is still healthy: yes — this is where hip preservation earns its name. A labrum torn at the rim can be reattached rather than trimmed away, restoring the seal that keeps the joint lubricated. Extra bone that has been jamming into the rim with every deep bend can be reshaped so it clears. A fragment floating in the joint can be removed, and a capsule stretched by repeated instability can be tightened. Where the shape and the tear are corrected together, people who could not sit through a meeting or squat without catching frequently return to full activity.
Established arthritis: no. Once the cartilage lining has worn through, tidying a torn labrum inside that joint does not relieve the pain, and studies of arthroscopy in arthritic hips show high rates of progression to replacement within a couple of years. Offering it anyway would buy you a recovery period and change nothing. The same caution applies where the socket is too shallow: reshaping the rim of an already under-covered hip can leave it less stable rather than more, which is why that hip is assessed as a different problem with a different operation.
Hip arthroscopy is a well-established operation, and serious complications are uncommon. The one worth explaining properly is the traction. Because the ball fits so tightly into the socket, the leg must be pulled gently to open a working gap — and that pull, held against a padded post, can leave temporary numbness in the groin or the outer thigh. It is the commonest side effect of this operation, it usually resolves within days to weeks, and surgical time under traction is deliberately kept as short as possible for exactly this reason.
Beyond that, the risks are those of any joint surgery: infection, clots in the leg, and stiffness. A small proportion of people form extra bone around the joint afterwards, which can be managed. And some hips need further surgery — either because the labrum fails to heal, or because the cartilage inside turns out more worn than the scans suggested. Every one of these is discussed before you decide, alongside how likely it is in your particular hip.
Longer than the keyhole scars suggest. The skin heals in a fortnight; a repaired labrum takes months, and the rehabilitation that rebuilds control around it takes longer still. Crutches are usual for two to four weeks, desk work returns at two to three, driving at around four to six weeks, and running at roughly three months. Competitive sport sits between four and nine months. Where are you in this?
The decision turns on two things: what the imaging shows, and how much rehabilitation you have genuinely done. A structured programme deserves a fair trial first — many hips settle with it. Where mechanical symptoms persist and the cartilage is still healthy, surgery has a strong case.
Arrive strong. Hips that go into this operation with good gluteal and trunk strength recover faster afterwards, and the weeks before surgery are free training time most people waste. Arrange crutches, plan two to three weeks of lighter duties, and expect to be sitting on higher chairs for a while.
Recovery is a staged programme, not a waiting period. Range first, then strength, then speed and finally sport-specific work — each cleared before the next. Progress feels slow between weeks six and twelve; that is normal, and it is where the rehabilitation quietly does its work.
It can, and the reasons are worth naming. A repaired labrum can fail to heal or tear again, particularly in hips that return to heavy end-range loading early. Extra bone occasionally re-forms where it was reshaped. And in a joint whose cartilage was already thinning, the wear continues regardless of how well the labrum was fixed — the operation treated the rim, not the lining.
What most reliably prevents a repeat is correcting the cause in the first operation. Reattaching a labrum while leaving the bone that tore it is the commonest reason results disappoint, which is why the shape is measured beforehand and addressed at the same time. After that, the protection is rehabilitation completed rather than abandoned at the point comfort returns — a familiar theme, and a true one.
Many hips do not, and a fair trial of proper rehabilitation comes first for almost everyone. Hip arthroscopy earns its place in specific situations — check yours:
That is the picture hip arthroscopy is genuinely for. The next step is a consultation rather than a consent form: confirming the shape on X-ray, the tear on MRI, and the state of the cartilage — because that last one decides whether this operation helps or merely delays a better one.
Good news — keyhole hip surgery probably isn’t your answer. Groin pain without mechanical symptoms, and hips that have not yet had a proper strengthening programme, usually do better without an operation. An assessment builds that plan and keeps watch for the exceptions.
And remember: the consultation’s job is the right answer for your hip — including “no operation.”
Tap each card to reveal the answer:
Keyhole surgery to the hip joint. Two or three small incisions allow a camera and instruments into a joint that sits deep beneath thick muscle, and because the ball fits so tightly into the socket, the leg is gently pulled to open a working space of a few millimetres. Through that space the labrum can be repaired, the bone reshaped where it pinches, loose fragments removed and the capsule repaired — all without opening the joint.
Chiefly impingement and labral tears in younger hips: reshaping the bone that causes the pinching and reattaching the torn labrum, usually in the same operation. It is also used for loose fragments inside the joint, some cartilage injuries, and occasionally to repair gluteal tendons or release a snapping tendon. It is not an operation for established arthritis, where results are poor and a replacement is the more honest answer.
Longer than most people expect, and considerably longer than knee arthroscopy. Crutches are usual for two to four weeks, desk work returns at two to three weeks, driving at around four to six, and running at roughly three months. Return to competitive sport typically falls between four and nine months depending on what was done. The rehabilitation is not optional — it is most of the treatment.
The commonest is temporary numbness in the groin or thigh from the traction used to open the joint, which usually settles within weeks. Less common are infection, clots, extra bone forming around the joint, ongoing stiffness, and the need for further surgery — including progression to a replacement if the cartilage was more worn than expected. Serious complications are uncommon in experienced hands.
It is a reasonable hope rather than a proven promise. Correcting the shape that grinds the rim and repairing the labrum restores more normal mechanics, and the argument for treating a symptomatic young hip rests partly on that. What has not been demonstrated is that the operation reliably prevents arthritis decades later. It is offered to relieve current symptoms in a hip with a fixable mechanical problem.
They answer different problems, and the cartilage decides which is yours. Hip arthroscopy is hip preservation surgery: it keeps your own joint, repairing the labrum and reshaping bone in a hip whose cartilage is still largely healthy, and it suits younger, active people with a mechanical problem. Hip replacement removes the worn surfaces and replaces them, which is what an arthritic or collapsed hip needs. Performing arthroscopy on a hip that has already lost its cartilage tends to lead to a replacement within a couple of years anyway, so the assessment before surgery is largely about establishing which of the two operations your hip is actually asking for.
Related: hip impingement · hip labral tears · hip dysplasia · all hip surgery · physiotherapy
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