Hip arthroscopy has transformed the way certain hip conditions are diagnosed and treated – particularly in younger and more active patients who aren’t yet at the stage of needing a hip replacement. But it isn’t the right procedure for everyone and understanding whether you’re likely to benefit is an important first step.
Consultant orthopaedic surgeon Mr Nirav Shah has a particular interest in hip arthroscopy and is one of only a few surgeons in the UK to offer the procedure. Here’s what it involves, who it’s most likely to help and what to consider before deciding whether it’s right for you.
What is hip arthroscopy?
Hip arthroscopy is a minimally invasive, keyhole procedure that allows Mr Shah to see inside the hip joint, diagnose any damage and, in most cases, treat it at the same time. A thin fibre optic scope – just a few millimetres wide – is inserted through a small incision, projecting the inside of the joint onto a screen.
The procedure is carried out under general anaesthetic as a day case, meaning most patients go home on the same day. Because it avoids the need for more invasive open surgery, recovery is typically faster, with less swelling, reduced scarring and a lower risk of complications.
What conditions can it treat?
Hip arthroscopy is used to investigate and treat a range of conditions, including:
Hip impingement (FAI)
Femoroacetabular impingement occurs when there is abnormal contact between the bones of the hip joint during movement. Left untreated, it can damage the labrum and accelerate the onset of arthritis. Hip arthroscopy allows Mr Shah to reshape the bone and address the impingement directly.
Labral tears
The labrum is the ring of cartilage that lines and deepens the hip socket. When it tears – often as a result of impingement, injury or repetitive movement – arthroscopy can be used to repair or trim the damaged tissue.
Early arthritis
In carefully selected patients, hip arthroscopy can help manage the symptoms of early arthritis and may slow its progression, potentially delaying or reducing the need for joint replacement in the future.
Loose bodies
Small fragments of bone or cartilage can sometimes break off within the joint, causing pain and restricted movement. These can be removed arthroscopically.
Inflamed tissue
Synovitis – inflammation of the lining of the joint – can also be addressed during the procedure.
Who is a good candidate?
Hip arthroscopy tends to produce the best results in patients who:
Have a suspected structural problem. The procedure works best where there is a suspected underlying cause – such as impingement or a labral tear. A thorough assessment, including imaging such as X-ray, CT or MRI, helps Mr Shah build a clear picture of what’s going on before any decision is made.
Are younger and more active. Hip arthroscopy is particularly well suited to patients in their 20s, 30s and 40s who want to remain active and are looking for a solution that addresses the underlying problem rather than simply managing symptoms.
Have not yet developed significant arthritis. Once arthritis is advanced, the cartilage damage is too extensive for arthroscopy to be of meaningful benefit. In these cases, hip replacement is likely to be the more appropriate option.
Have not responded to conservative treatment. Physiotherapy, activity modification and cortisone injections are usually explored first. If these haven’t provided adequate relief and symptoms are affecting quality of life, surgery may be the right next step.
Are in good general health. As with any procedure carried out under general anaesthetic, overall health and fitness play a role in suitability and recovery.
Who may not be suitable?
Hip arthroscopy is not appropriate for everyone. Patients with moderate to severe osteoarthritis, significant joint space narrowing or certain structural abnormalities of the hip are unlikely to achieve a good outcome from arthroscopy alone and may be better suited to other treatments.
This is why a thorough assessment is essential before any decision is made. Mr Shah will review your symptoms, examine the joint and use imaging to build a clear picture of what’s going on before recommending a course of action.
What does recovery look like?
Most patients return to work and resume daily activities within one to three weeks. More vigorous activity and sport typically take around six weeks, though this depends on the nature of the procedure and individual progress. Mr Shah will provide full aftercare guidance and arrange follow-up appointments to monitor your recovery closely.
Is hip arthroscopy right for you?
If you’re experiencing hip or groin pain that hasn’t improved with conservative treatment, and you’re wondering whether hip arthroscopy might help, the best place to start is a consultation with Mr Shah. With more than 15,000 orthopaedic procedures performed and a particular interest in hip arthroscopy for impingement and early arthritis, he will assess your situation carefully and advise on the most appropriate path forward.
