Hip arthroscopy is minimally invasive “keyhole” surgery used to diagnose and treat problems inside the hip joint. A small camera (arthroscope) and fine instruments are passed through two or three small incisions, giving a magnified, high-definition view of the joint without the large incision of open surgery. Dr. Andrew Dold has subspecialty training in hip arthroscopy and has published research on hip arthroscopy in the American Journal of Sports Medicine and JBJS Reviews.
- Two to three small incisions; usually 60 to 90 minutes
- Outpatient: most patients go home the same day
- Physical therapy starts within a few days; stationary cycling often within a week
- Total recovery usually about 3 to 6 months; many return to sport around 5 months
- Treating FAI and labral tears early may help protect the hip joint
What conditions can hip arthroscopy treat?
- Femoroacetabular impingement (FAI): extra bone on the ball (cam) or rim of the socket (pincer) that pinches the joint
- Labral tears: tears of the cartilage rim around the socket, often caused by FAI; the labrum is repaired whenever possible
- Cartilage damage and loose bodies: loose fragments of cartilage or bone that catch inside the joint
- Synovitis: inflamed joint lining
- Snapping hip and psoas tendon problems
- Gluteus medius and minimus tears, which can often be repaired endoscopically
Am I a candidate for hip arthroscopy?
Good candidates usually have:
- Groin or deep hip pain, clicking, catching or locking, often worse with sitting, squatting, twisting or sports
- A structural problem such as FAI or a labral tear confirmed on exam and imaging
- Pain that has not improved with non-surgical treatment. In a randomized trial of 348 patients with FAI, both hip arthroscopy and a personalized physical therapy program improved symptoms, and arthroscopy led to a greater, clinically meaningful improvement at 12 months.1
- Little or no arthritis in the joint. Research shows patients with more than early arthritis are less likely to benefit from hip arthroscopy and more likely to need a hip replacement later.2
Hip arthroscopy is usually not the right treatment for a hip with moderate or advanced arthritis. In that case, hip replacement may be the better option, and Dr. Dold will explain why.
Your hip evaluation with Dr. Dold
Every evaluation begins with your history and a detailed hip exam, then X-rays taken from several angles to study the shape and alignment of the joint. When needed, an MRI or CT scan helps confirm labral and cartilage injuries. Many patients improve without surgery using physical therapy, activity changes, image-guided injections or PRP, and these are often tried first. Not sure what is causing your pain? Our hip pain guide explains common causes, and Dr. Dold also offers second opinions.
What happens during hip arthroscopy?
The surgery is done under anesthesia, typically as an outpatient. Gentle traction creates space in the joint so the arthroscope and instruments can be inserted through two or three small incisions. Depending on what is found, Dr. Dold may reshape the bone causing impingement, repair the labrum with small anchors (in a review of 2,730 hips, repairing the labrum rather than trimming it was linked to less pain long term and a lower chance of later hip replacement, 3.5% vs 7.4%),3 treat damaged cartilage and remove loose fragments. The procedure usually takes about 60 to 90 minutes, and most patients go home the same day.
Watch Dr. Dold explain hip arthroscopy
Hip arthroscopy recovery
| Time after surgery | Typical milestones |
|---|---|
| First days | Home the same day; physical therapy begins within a few days; crutches with protected (toe-touch) weight bearing and a hip brace for about 4 weeks to protect the repair |
| Week 1 | Many patients start stationary cycling |
| Weeks 2–6 | Gradual increase in weight bearing and motion; wean off crutches after about 4 weeks |
| Months 2–3 | Strengthening of the hip and core; return to most daily activities |
| Months 3–6 | Running and sport-specific training; many patients return to sport or full activity around 5 months |
Your exact plan depends on what was repaired, and Dr. Dold will give you a specific timeline. In a review of 1,124 patients, about 71% returned to work, at an average of about 115 days after surgery; return was quicker for lighter jobs.4
Risks of hip arthroscopy
Hip arthroscopy is generally safe, but risks include temporary numbness from traction, stiffness, infection, blood clots, persistent pain, and in some patients the need for further surgery or eventual hip replacement. Dr. Dold reviews these with you before surgery.
Patient experience
Watch Dr. Dold: hip arthroscopy
Some of these videos show real surgery, so some viewers may prefer not to watch.
More videos on Dr. Dold’s YouTube channel.
What the research shows
- Arthroscopy vs. physiotherapy: three randomized trials (FASHIoN in the UK, FAIT in the UK and FAIR in Australia) found that both treatments help, but hip arthroscopy improved hip-related quality of life more than a structured physiotherapy program for symptomatic hip impingement (FAI syndrome). Because many patients also improve with therapy, a trial of rehabilitation remains a reasonable first step.
- Repair, not removal: repairing the labrum gives better outcomes than trimming it away, and closing the capsule at the end of surgery improves results and lowers the risk of instability.
- Patient selection is key: patients with established arthritis (joint space of 2 mm or less) are much less likely to benefit, and in long-term series some patients eventually need hip replacement. In carefully selected patients over 40 with limited arthritis, a randomized trial still showed benefit.
- Return to sport: most athletes, including elite athletes, return to sport after hip arthroscopy; about 1 in 8 do not, usually because of persistent pain.
- Rehabilitation: a structured, supervised physiotherapy program after surgery improves recovery.
Research cited on this page
- Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018;391(10136):2225-2235. PubMed
- Domb BG, Gui C, Lodhia P. How much arthritis is too much for hip arthroscopy: a systematic review. Arthroscopy. 2015;31(3):520-529. PubMed
- Bohn DS, Bigarella LG, Gusmão PDF, et al. Arthroscopic labral repair versus debridement for femoroacetabular impingement: a systematic review and meta-analysis of 2730 hips. Am J Sports Med. 2026 (online ahead of print). PubMed
- Blaeser AM, Mojica ES, Mannino BJ, Youm T. Return to work after primary hip arthroscopy: a systematic review and meta-analysis. Am J Sports Med. 2023;51(5):1340-1346. PubMed
- Griffin DR, Dickenson EJ, Achana F, et al. Arthroscopic hip surgery compared with personalised hip therapy in people over 16 years old with femoroacetabular impingement syndrome: UK FASHIoN RCT. Health Technol Assess. 2022;26(16):1-236. PubMed
FASHIoN full report: arthroscopy gave greater quality-of-life improvement than personalized physiotherapy and was likely cost-effective. - Palmer AJR, Ayyar Gupta V, Fernquest S, et al. Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial. BMJ. 2019;364:l185. PubMed
UK FAIT trial (BMJ): arthroscopic surgery gave better outcomes than physiotherapy and activity modification for symptomatic FAI. - Palmer A, Fernquest S, Rombach I, et al. Medium-term results of arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of femoroacetabular impingement syndrome: a multi-centre randomised controlled trial. Br J Sports Med. 2025;59(2):109-117. PubMed
FAIT medium-term results: surgery gave better pain and function and less MRI cartilage damage, with no difference in X-ray arthritis progression. - Hunter DJ, Eyles J, Murphy NJ, et al. Multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapist-led care for femoroacetabular impingement (FAI) syndrome on hip cartilage metabolism: the Australian FASHIoN trial. BMC Musculoskelet Disord. 2021;22(1):697. PubMed
Australian FAIR trial: both groups improved; arthroscopy gave a clinically important improvement in hip quality of life at 12 months. - Dwyer T, Whelan D, Shah PS, et al. Operative Versus Nonoperative Treatment of Femoroacetabular Impingement Syndrome: A Meta-analysis of Short-Term Outcomes. Arthroscopy. 2020;36(1):263-273. PubMed
Meta-analysis: hip arthroscopy gave better short-term hip outcomes than physical therapy alone. - Gatz M, Driessen A, Eschweiler J, et al. Arthroscopic surgery versus physiotherapy for femoroacetabular impingement: a meta-analysis study. Eur J Orthop Surg Traumatol. 2020;30(7):1151-1162. PubMed
Meta-analysis of three high-quality RCTs: arthroscopy was more effective than physiotherapy for FAI. - Lamo-Espinosa JM, Mariscal G, Gómez-Álvarez J, et al. Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: a systematic review and meta-analysis of randomized clinical trials. Sci Rep. 2023;13(1):16493. PubMed
Meta-analysis: arthroscopy improved scores more than non-operative care, though differences did not always reach the clinically important threshold. - Kim CH, Moon JK, Yoon JY, et al. Arthroscopy versus nonoperative treatment of symptomatic femoroacetabular impingement syndrome: A systematic review and meta-analysis. Medicine (Baltimore). 2020;99(49):e23247. PubMed
Meta-analysis: arthroscopy improved iHOT-33 scores at 12 months, with mixed results on other measures. - Martin SD, Dean MC, Gillinov SM, et al. Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: 24-Month Results From a Randomized Controlled Trial. Am J Sports Med. 2024;52(10):2574-2585. PubMed
Randomized trial: in patients 40 and older with limited arthritis, arthroscopy plus therapy gave better 2-year outcomes than therapy alone. - Ayeni OR, Adamich J, Farrokhyar F, et al. Surgical management of labral tears during femoroacetabular impingement surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2014;22(4):756-62. PubMed
Systematic review: labral repair gave better outcomes than debridement in most studies. - Wu ZX, Ren WX, Ren YM, et al. Arthroscopic labral debridement versus labral repair for patients with femoroacetabular impingement: A meta-analysis. Medicine (Baltimore). 2020;99(19):e20141. PubMed
Meta-analysis: labral repair improved function and satisfaction compared with debridement. - Economopoulos KJ, Chhabra A, Kweon C. Prospective Randomized Comparison of Capsular Management Techniques During Hip Arthroscopy. Am J Sports Med. 2020;48(2):395-402. PubMed
Randomized trial: complete capsular closure improved patient-reported outcomes compared with leaving the capsule open. - Riff AJ, Kunze KN, Movassaghi K, et al. Systematic Review of Hip Arthroscopy for Femoroacetabular Impingement: The Importance of Labral Repair and Capsular Closure. Arthroscopy. 2019;35(2):646-656.e3. PubMed
Systematic review: conversion to hip replacement was under 10% in most series; labral repair and capsular closure were associated with lower conversion. - Duplantier NL, McCulloch PC, Nho SJ, et al. Hip Dislocation or Subluxation After Hip Arthroscopy: A Systematic Review. Arthroscopy. 2016;32(7):1428-34. PubMed
Systematic review: instability after arthroscopy was linked to undercoverage, labral debridement, capsular insufficiency and iliopsoas release. - Migliorini F, Vaishya R, Simeone F, et al. Long-term outcomes of arthroscopic management of femoroacetabular impingement syndrome: a systematic review. Arch Orthop Trauma Surg. 2025;145(1):267. PubMed
Systematic review at about 11 years: outcomes improved, but 32% needed hip replacement within ten years, highlighting the importance of patient selection. - Kyin C, Maldonado DR, Go CC, et al. Mid- to Long-Term Outcomes of Hip Arthroscopy: A Systematic Review. Arthroscopy. 2021;37(3):1011-1025. PubMed
Systematic review: mid- to long-term improvements after primary hip arthroscopy, with variable revision and conversion rates. - Minkara AA, Westermann RW, Rosneck J, et al. Systematic Review and Meta-analysis of Outcomes After Hip Arthroscopy in Femoroacetabular Impingement. Am J Sports Med. 2019;47(2):488-500. PubMed
Meta-analysis: a high percentage of patients return to sport after arthroscopy for FAI, with low complication rates. - Weber AE, Bolia IK, Mayfield CK, et al. Can We Identify Why Athletes Fail to Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Systematic Review and Meta-analysis. Am J Sports Med. 2021;49(6):1651-1658. PubMed
Meta-analysis: about 12% of athletes did not return to sport, mostly due to persistent hip pain. - Elwood R, El-Hakeem O, Singh Y, et al. Outcomes and rate of return to play in elite athletes following arthroscopic surgery of the hip. Int Orthop. 2021;45(10):2507-2517. PubMed
Systematic review: most elite athletes return to the same level of competition after hip arthroscopy. - Horner NS, Ekhtiari S, Simunovic N, et al. Hip Arthroscopy in Patients Age 40 or Older: A Systematic Review. Arthroscopy. 2017;33(2):464-475.e3. PubMed
Systematic review: patients 40 or older improved with osteoplasty and labral repair, while debridement alone was less successful. - Bennell KL, Spiers L, Takla A, et al. Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR). BMJ Open. 2017;7(6):e014658. PubMed
Randomized pilot: a supervised physiotherapy program after arthroscopy improved hip outcomes at 14 weeks.
Why see Dr. Dold
- Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
- Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
- Fellow of the American College of Surgeons (FACS), the American Academy of Orthopaedic Surgeons (FAAOS), the American Orthopaedic Association (FAOA) and the Royal College of Surgeons of Canada (FRCSC)
- Published research on hip arthroscopy, including Post-operative Considerations Following Hip Arthroscopy (JBJS Reviews, 2017) and studies in the American Journal of Sports Medicine; member of the International Society for Hip Arthroscopy (ISHA)
- Team physician and surgical consultant to Rugby Canada; has cared for professional and Olympic athletes from the NFL, NBA, NHL, MLS, PGA Tour, Major League Rugby and USA Gymnastics
- D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google
Frequently asked questions
Is hip arthroscopy major surgery?
Hip arthroscopy is minimally invasive surgery done through two or three small incisions, and most patients go home the same day. It is still real surgery with a structured recovery, but it is far less invasive than open hip surgery.
How long does hip arthroscopy take?
The procedure usually takes about 60 to 90 minutes.
How long is recovery after hip arthroscopy?
Physical therapy starts within a few days, many patients begin stationary cycling within a week, and total recovery is usually about 3 to 6 months. Many patients return to sport or full activity around 5 months.
Will I need crutches after hip arthroscopy?
Most patients use crutches with protected (toe-touch) weight bearing and a hip brace for about 4 weeks to protect the repair. Dr. Dold will tell you how long based on what was repaired.
What does hip arthroscopy fix?
It treats problems inside the hip such as femoroacetabular impingement (FAI), labral tears, loose bodies, cartilage damage and synovitis, and some tendon problems around the hip.
Can hip arthroscopy prevent arthritis or hip replacement?
Treating FAI and labral tears early may help protect the joint and delay arthritis in some patients, but it cannot guarantee that arthritis or a hip replacement will never be needed.
Is hip arthroscopy right for hip arthritis?
Usually not. Hip arthroscopy tends to help most when there is little or no arthritis. For moderate or advanced arthritis, hip replacement is often the better option.
Do I have to try physical therapy first?
Many patients improve with physical therapy, activity changes, injections or PRP, and these are often tried before surgery. Dr. Dold will recommend the right approach for you.
Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice. Individual results vary.
