Hip Arthroscopy

A hip arthroscopy is a minimally invasive procedure that can be used to treat conditions in your hip. It involves making a small incision near the hip joint through which a tiny tube with a small camera and light is inserted.

Also known as: hip scope, labral repair or osteoplasty

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Everything you need to know

A surgeon can use this method to treat issues such as:

Hip impingement: This is when an unusually shaped hip joint creates friction between the thighbone and hip socket, causing pain and limiting motion.
Labral tears: This is when the soft tissue in your hip (labrum) is injured.
Loose bone or cartilage: If your hip bones or cartilage have been damaged, your surgeon can any remove loose pieces that are causing you pain.
Dysplasia: This is where your thighbone does not align as it should with the pelvis.
Tendon tears: Tendons attach your muscles to your bones. Your surgeon can repair injured tendons or re-attach any that have torn away from the bones.
Tendon releases: Tendons that are too tight can be loosened, reducing your pain and improving your range of motion.

Usually, your doctor will only advise an arthroscopy if they know the cause of your pain and other treatments such as physiotherapy and steroid injections haven’t worked.

Hip arthroscopy vs. total hip replacement

Hip arthroscopy is much less invasive than a total hip replacement. For many people, an arthroscopy is a good treatment option to resolve pain or mobility issues in the hips. If an arthroscopy isn’t successful — or if your symptoms warrant a more invasive treatment — your doctor may recommend a hip replacement. People with significant damage to their cartilage or who have severe arthritis usually need total hip replacements.

Before Surgery

An arthroscopy is an outpatient procedure. This means you can be treated and go home the same day.

Before your hip arthroscopy, you might need to:

Stop taking certain medications: Tell your doctor everything you’re taking — including over-the-counter medicines or herbal supplements. If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
Stop smoking if you can, as smoking makes it harder for your body to heal after a surgery.
You should stop eating six hours before your procedure and stop drinking (including water) two hours before. You should also not chew gum or suck boiled sweets from two hours before.

On surgery day, it’s a good idea to wear loose, comfortable clothing and bring a small bag with things you might need during your stay. Items to remember include a toothbrush and toothpaste, your phone and a charger, a book, any prescription medications and a change of clothes. Your doctor will let you know if you can take any medications with a sip of water before surgery or if you should wait until after.

Once you have arrived and are settled in your room, a nurse will monitor your vital signs (such as body temperature and blood pressure) and run through your medical history, medications and emergency contacts.

Your doctor will then once again run you through the procedure and ask you to sign a consent form.

During surgery

You will be given a spinal anaesthetic and sedation, so you will be asleep for your procedure. Unlike general anaesthesia you will be breathing on your own, so will not need a breathing tube. Spinal anaesthesia is preferable as your recovery will be faster and side effects such as nausea and sickness will be reduced.

Your surgeon will start by making a few tiny cuts in the skin of your hip. Through this they will insert the arthroscope, which is a small tube with a light and camera. Other small surgical tools can also be inserted through these incisions.

Most arthroscopies take around 90 minutes.

After Surgery

Once we’re happy you’re doing well, we will take you to your private room where you can start your recovery. Our nursing team will make some checks, and once you have had a drink and some food, you can home. You should be collected and taken home as you are not allowed to drive after sedation. You should also avoid cooking and not make any important decisions for the rest of the day, as sedation can make you feel slightly unsteady and confused.

For the first week after surgery, you should not put any weight on your hip. This will also mean not sleeping on one side.

For three weeks, you may need to wear a hip brace and you will need to use crutches for 4 -6 weeks to help you avoid putting your full weight on the treated hip. You should also take pain relief when needed, keep the incisions clean and dry and only have showers whilst they are healing.

Typically, most people who have a hip arthroscopy can expect to gain full mobility within eight weeks of their surgery. During this time, you will need to build up your strength by walking and keep your hip mobilised with gentle movement. Consistently and regularly doing your physiotherapy rehab exercises is essential to your recovery. We have an excellent therapies team at St John & St Elizabeth Hospital that can support you throughout your recovery. You should not drive until either you are walking normally without crutches, or your doctor has confirmed you can at your 6-week check-up. Most people can return to work after six weeks. However, if you have a physical job or a job where you stand for long periods, you may need to wait 12 weeks before returning to work.

You should be able to start moderate exercise, such as cycling or swimming, within a few weeks, sports training at 12 weeks and competitive sports after 6 months.

For some people, a full recovery can take a year, particularly if your symptoms have stretched back many years.

Medically reviewed by Mr Sujith Konan - MBBS MD(res) MRCS FRCS(Tr&Orth), Honorary Associate Professor (UCLH)

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.

Find out more

Appointment

You will have an initial consultation with a lower limb orthopaedic surgeon.

Treatment plan

During this appointment, you’ll go through your medical history, the risk and benefits of an arthroscopy and what to expect from recovery. Together, you will decide whether this procedure is the best option for you.

Pre-op assessment

If you decide to go ahead with the procedure, you will need to come in for a pre-assessment, which is a standard ‘fitness for surgery’ check.

Surgery

The procedure itself should take around 90 minutes. You will be able to go home the same day. However, you will need to be collected from hospital as you are not allowed to drive after sedation.

Aftercare

You will need to keep your wounds clean and dry, take pain relief and have physiotherapy consistently. You will not be able to fly short haul for six weeks or long haul for 12 weeks. We have an excellent therapies team at our hospital that can support you throughout your recovery.

Follow-Up

You will have a follow-up appointment with your doctor at two weeks, where stitches will be removed. You should also have follow-ups at 6 weeks, 3 months, and if needed, at 6 months.