Hip arthroscopy for femoroacetabular impingement is performed through 2-3 small portals. Recovery requires a structured rehabilitation programme.
ℹ️ As this is performed under general anaesthetic, blood tests and a health check are performed at your pre-assessment.
Hip arthroscopy takes approximately 60-90 minutes under general anaesthetic. Most patients go home the same day or the following morning.
Routine pre-operative assessment for general anaesthetic.
Blood-thinning medications must be paused. Inform your team of all medications.
You will use crutches for 2-4 weeks after surgery. Arrange these in advance.
You cannot drive home after general anaesthetic. Arrange a lift home.
Completing a pre-operative physiotherapy programme before arthroscopy improves outcomes. If you have not had supervised physiotherapy, discuss this with your surgeon.
ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
Most patients having arthroscopic or day-case procedures go home on the day of surgery. Those having joint replacement typically stay 1–2 nights. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
A nurse will check the wound before you leave and explain how to keep it clean and dry.
You will receive a letter for your GP and details of your next outpatient appointment - usually at 2 weeks for a wound check.
Arrange for a family member or friend to collect you. You must not drive on the day of surgery if you have had a general anaesthetic or sedation.
⚠️ Important: If you develop increasing hip pain, fever, or wound discharge after hip arthroscopy, contact your surgical team or attend A&E. Infection after hip arthroscopy is rare but requires prompt assessment.
Avoid getting the wound wet until it is fully healed - usually 10–14 days. Use a waterproof cover or cling film when showering.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective.
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, or a temperature above 38°C - these may indicate infection.
60-90 minutes in theatre. Most patients go home the same day.
Crutches for 2-4 weeks to protect the repaired labrum. Passive hip range of motion exercises begin.
Weight-bearing without crutches. Physiotherapy progresses to active strengthening.
Progressive running programme begins. Straight-line sport at 3-4 months.
Return to cutting and pivoting sport at 4-6 months, guided by functional testing.
Most patients return to driving at 3-4 weeks, when they are off crutches and have adequate hip strength to control the vehicle safely.
Return to straight-line sport at 3-4 months and cutting or pivoting sport at 4-6 months, guided by physiotherapy-based functional testing.
Hip arthroscopy is most effective in patients without significant pre-existing arthritis (Tonnis Grade 0-1). Patients with Grade 2-3 arthritis have less predictable outcomes and should discuss realistic expectations with their surgeon.
The aim of hip arthroscopy is to relieve groin pain caused by impingement, restore normal hip movement, and allow return to sport. The FAIT trial (Lancet 2018) demonstrated significantly better outcomes for surgery versus physiotherapy alone at 12 months for patients with symptomatic FAI and labral tears.
Under general anaesthetic, the hip is placed in traction to create space within the joint. Two to three small portals (incisions) are made around the hip. The cam deformity (bony bump on the femoral head-neck junction) is reshaped using an arthroscopic burr (osteoplasty). Acetabular rim trimming is performed if there is pincer impingement. The torn labrum is repaired to the acetabular rim using suture anchors. Takes approximately 60-90 minutes.
A structured hip strengthening and movement retraining programme. The FAIT trial showed physiotherapy produces good outcomes but significantly inferior to surgery at 12 months for symptomatic FAI with labral tear. Appropriate as the first-line treatment.
If symptoms are mild and the patient can modify activities to avoid impingement, observation is reasonable. Untreated FAI may lead to progressive labral and cartilage damage and early-onset hip arthritis.
Not appropriate at this stage. Hip replacement is reserved for advanced arthritis. FAI surgery aims to delay or prevent the progression to arthritis.
The lateral femoral cutaneous nerve, pudendal nerve, and sciatic nerve are at risk. The lateral femoral cutaneous nerve is most commonly affected (causing numbness on the outer thigh from traction). Usually temporary.
Traction on the hip to create space for the arthroscope can cause pressure on the perineum (pudendal nerve injury, labial or scrotal swelling) and foot/ankle. These are usually temporary.
Irrigation fluid can occasionally track into the abdominal cavity. Usually resolves spontaneously but may require urgent assessment.
Abnormal bone formation around the hip following cam resection. May limit movement. Prophylaxis with a short course of anti-inflammatory medication (indomethacin) is routinely given.
Not all patients achieve significant symptom relief. Those with pre-existing significant arthritis (Tonnis Grade 2-3) have less predictable outcomes and are at higher risk of requiring hip replacement.
Infection after hip arthroscopy is rare.
Expected after hip arthroscopy and from the perineal post used for traction.
From traction on the lateral femoral cutaneous nerve. Usually resolves within 1-4 weeks.
The hip is sore and stiff for 2-4 weeks after arthroscopy.
Untreated symptomatic FAI with a labral tear is associated with progressive cartilage damage and a risk of early-onset hip osteoarthritis. Surgery is associated with significantly better outcomes than physiotherapy alone at 12 months. However, surgery is not appropriate if there is already advanced arthritis, where hip replacement would be more appropriate.