Definition

Hip arthroscopy is surgery that is done by making small cuts around your hip and looking inside the joint using a tiny camera. Other medical instruments may also be inserted to examine or treat your hip joint.

Alternative Names

Arthroscopy - hip; Hip impingement syndrome - arthroscopy; Femoral-acetabular impingement - arthroscopy; FAI - arthroscopy; Labrum - arthroscopy

Description

During arthroscopy of the hip, the surgeon uses a tiny camera called an arthroscope to see inside your hip joint.

• An arthroscope is made up of a tiny tube, a lens, and a light source. A small surgical cut is made to insert it into your body.
• The surgeon will look inside your hip joint for damage or disease.
• Other medical instruments may also be inserted through one or two other small surgical cuts. This allows the surgeon to treat or fix certain problems, if needed.
• Your surgeon may remove extra pieces of bone that are loose in your hip joint, or fix cartilage or other tissues that are damaged.

Spinal, epidural, or general anesthesia will be used in most cases, so you will not feel pain. You may also be asleep or receive medicine to help you relax.

Why the Procedure Is Performed

The most common reasons for hip arthroscopy are to:

• Remove small pieces of bone or cartilage that may be loose inside your hip joint and causing pain.
• Treat hip impingement syndrome (also called femoral-acetabular impingement, or FAI). This procedure is done when other treatment has not helped the condition. The surgery is performed to remove excess bone that formed along the hip joint, causing the bones to develop an irregular shape and rub against one another.
• Repair a torn labrum (a tear in the cartilage that is attached to the rim of your hip socket bone).
• Repair of your hip tendons.

Less common reasons for hip arthroscopy are:

• Hip pain that does not go away and your surgeon suspects a problem that hip arthroscopy can fix. Most of the time, your surgeon will first inject numbing medicine into the hip to see if the pain goes away.
• Release of your hip tendons that may be snapping.
• Inflammation in the hip joint that is not responsive to nonoperative treatment.

If you do not have one of these problems, hip arthroscopy will probably not be useful for treating your hip arthritis.

Risks

The risks for any anesthesia and surgery are:

• Allergic reactions to medicines
• Breathing problems
• Bleeding
• Infection

Other risks from this surgery include:

• Bleeding into the hip joint
• Damage to the cartilage or ligaments in the hip
• Blood clot in the leg
• Injury to a blood vessel or nerve
• Infection in the hip joint
• Hip stiffness
• Numbness and tingling in the groin and thigh
• Hip fracture

Before the Procedure

Tell your surgeon or nurse if:

• You are or could be pregnant
• You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription
• You have been drinking a lot of alcohol, more than 1 or 2 drinks a day

Planning for your surgery:

• If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your health care provider who treats you for these conditions.
• If you smoke, it’s important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
• If needed, prepare your home to make it easier to recover after surgery.
• Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the week before your surgery:

• You may be asked to stop taking medicines that make it harder for your blood to clot. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and vitamin E. Many prescription medicines are also blood thinners.
• You will be told to stop some of your diabetes and weight loss medications. They can affect your stomach and gut emptying and can affect anesthesia.
• Ask your surgeon which medicines you should still take on the day of your surgery.
• If you smoke, try to stop. Ask your provider for help. Smoking can slow down wound and bone healing.
• Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes outbreak, or other illness. If you do get sick, your surgery may need to be postponed.

On the day of your surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines you were told to take with a small sip of water.
• Follow instructions on when to arrive at the hospital. Be sure to arrive on time.

After the Procedure

Whether you fully recover after hip arthroscopy depends on what type of problem was treated.

If you also have arthritis in your hip, you will still have arthritis symptoms after hip surgery.

Outlook (Prognosis)

After surgery, you will need to use crutches for 2 to 6 weeks.

• During the first week, you should not place any weight on the side that had surgery.
• You will slowly be allowed to place more and more weight on the hip that had surgery after the first week.
• Make sure you check with your surgeon about when you will able to bear weight on your leg. The timeline on the amount of time it takes can vary depending on the type of procedure that was done.

Your surgeon will tell you when it is OK to return to work. Most people can go back to work within 1 to 2 weeks if they are able to sit most of the time.

You may be referred to physical therapy to begin an exercise program.

References

Harris JD. Hip arthroscopy. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 79.

Mijares MR, Baraga MG. Basic arthroscopic principles. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 8.