Hip Arthroscopy

Hip arthroscopy (also known as “hip scoping”) is an advanced, minimally invasive surgical procedure that allows surgeons to view, diagnose, and treat a variety of painful problems inside the hip joint. Unlike traditional open surgery, this technique uses a small camera (arthroscope) and specialized, thin instruments inserted through “keyhole” incisions, typically no larger than a buttonhole.

This procedure is a key part of hip preservation, which focuses on repairing damage and correcting underlying mechanical problems in the joint, rather than replacing it. The goal is to relieve pain, restore function, and potentially delay or prevent the future onset of hip arthritis. At Sano, our fellowship-trained specialists use these sophisticated techniques to help you get back to an active life.

Candidates for hip arthroscopy often experience persistent pain that hasn’t responded to non-surgical treatment. This pain is typically not from advanced arthritis, but from a specific mechanical issue.

Common indications include:

• A sharp, “clicking,” “catching,” or “popping” sensation deep within the hip joint during movement.
• Persistent pain in the groin, buttock, or front of the hip.
• Pain that worsens with prolonged sitting, deep squatting, or athletic activity.
• A feeling of stiffness or a “block” that limits the hip’s full range of motion.
• A feeling of instability or the hip “giving way.”

If you’re experiencing these mechanical symptoms, an evaluation with a Sano hip specialist can determine the cause.

Hip arthroscopy is designed to treat specific mechanical problems within the joint, most often seen in active individuals. The most common conditions we treat with this procedure are:

• Femoroacetabular Impingement (FAI): This is the most frequent cause. It’s a condition where extra bone growth (bone spurs) on the “ball” (cam) or “socket” (pincer) of the hip joint causes them to “impinge” or pinch, damaging the nearby cartilage.
• Labral Tears: A tear in the labrum, which is the soft cartilage ring that lines the rim of the hip socket. The labrum acts like a seal and helps provide stability. It is often torn as a result of FAI.
• Loose Bodies: Small pieces of bone or cartilage that have broken free and are floating inside the joint, causing catching and pain.

Risk factors often include a history of high-impact sports (like hockey, soccer, or ballet) that involve repetitive hip flexion and rotation.

Accurately identifying the source of your hip pain is our top priority. Our specialists use a comprehensive approach:

• Medical history & symptom review: We’ll discuss your activities, when the pain started, and what specific motions cause the “catching” or pain.
• Physical exam: Your specialist will perform specific tests, such as the FADIR test (flexion, adduction, and internal rotation), to check your range of motion and see if we can reproduce the pinching sensation.
• Imaging: X-rays are used to assess the bone structure and look for the tell-tale bone spur shapes of FAI. An MRI (often an MR-Arthrogram, where dye is injected into the joint) is the gold standard for getting a clear view of the labrum and confirming a tear.

Before considering surgery, we will almost always start with conservative treatments to manage your symptoms. These options include:

• Activity modification: Temporarily avoiding the specific activities or movements (like deep squats) that trigger your pain.
• Physical therapy: This is a crucial step. A physical therapist can help you strengthen the supporting muscles around the hip (like the glutes and core) to improve stability and mechanics.
• Anti-inflammatory medications (NSAIDs): To reduce pain and inflammation in the joint.
• Corticosteroid injection: An injection of a powerful anti-inflammatory medication directly into the hip joint. This can be both diagnostic (if the pain goes away, it confirms the hip joint is the source) and therapeutic (providing months of pain relief).

If your pain continues to limit your life despite non-surgical efforts, hip arthroscopy offers a definitive solution to fix the underlying mechanical problem. During this minimally invasive procedure, our surgeons will:

• Perform Labral Repair: The torn labrum is meticulously repaired and re-anchored to the rim of the hip socket using tiny sutures.
• Correct FAI (Osteoplasty): The abnormal bone spurs on the “ball” (cam) and/or “socket” (pincer) are carefully shaved down and reshaped to restore the normal anatomy, eliminating the “pinching” conflict.
• Address Other Issues: Any loose bodies are removed, and other cartilage damage can be addressed at the same time.

By correcting the root cause, this procedure aims to provide lasting pain relief and protect the joint from further damage.

Recovery from hip arthroscopy is a structured process that requires your active participation.

• Initial Phase: You will use crutches for several weeks to protect the repaired tissues, as we often limit the amount of weight you can put on your leg.
• Physical Therapy: Formal physical therapy is essential and will begin almost immediately. It starts with gentle range-of-motion exercises and progresses over several months to rebuilding strength, stability, and function.

Full Return to Activity: While you can often return to a desk job quickly, a full return to high-impact sports and activities is a gradual process that typically takes 6 to 9 months. This timeline ensures the repaired tissues have fully healed and your strength has returned.

• Expertise in Hip Preservation: Our orthopedic surgeons have fellowship training and extensive experience in hip arthroscopy and other complex hip-preservation techniques.
• Integrated Care: From your initial diagnosis through your surgery and dedicated physical therapy, your entire care team is coordinated under one roof.
• Patient-First Approach: We believe in clear, transparent communication and create personalized treatment plans that reflect your unique athletic or lifestyle goals.

Is groin or hip pain interfering with your daily life? Schedule an appointment to talk with our hip specialists. We can create a specific treatment plan to help you overcome your injury and move with confidence again.