At a glance
- What the surgery does
- Reshapes extra bone on the hip's ball or socket and repairs or trims a torn labrum, through small incisions with a camera.
- Why people consider it
- Hip or groin pain from femoroacetabular impingement that limits activity despite physical therapy, with little or no arthritis.
- The main choices
- Physical therapy or surgery. In two UK trials, surgery improved symptoms somewhat more at 8 to 12 months, and both helped.[2][3] Surgery is usually not a good option once arthritis is established.[7]
- What recovery involves
- Crutches for a few weeks, months of therapy, and about seven months on average before returning to sport.
- What to ask your surgeon
- Whether you truly have FAI syndrome, how much arthritis is in the hip, and what a good trial of physical therapy would look like first.
The short version
- Hip arthroscopy is mainly used for femoroacetabular impingement syndrome: hip pain from extra bone on the ball or socket that pinches with movement, often with a torn labrum.[1]
- In two UK trials, surgery improved hip symptoms more than physical therapy programs at 8 to 12 months, and both groups got better.[2][3] A smaller US military trial found no difference at two years.[4]
- Hip arthroscopy is generally not a good option once arthritis is established. Results in hips with moderate arthritis are unpredictable, and many go on to hip replacement.[7]
- About 3 in 4 athletes returned to their previous level of sport after FAI surgery, at about 7 months on average.[9]
- Major complications are rare, under 1%, but about 6% of people needed another operation within a couple of years in one large review.[6]
What femoroacetabular impingement is
The hip is a ball-and-socket joint. In FAI, the shape of the bones isn't quite round or the socket covers too much of the ball, so they pinch together when the hip bends and turns.
- Cam type: extra bone on the ball or femoral neck.
- Pincer type: the rim of the socket overhangs.
- Many people have both.
The pinching can tear the labrum, a ring of cartilage around the socket, and wear the joint cartilage. Typical symptoms are deep groin or hip pain with sitting, squatting, getting in and out of a car, or pivoting sports.[12][15]
The shape alone isn't enough to diagnose the problem. Many people without hip pain have cam or pincer shapes on X-ray. An international consensus (the Warwick Agreement) defined FAI syndrome as the combination of symptoms, examination findings and imaging, and recommended physical therapy, activity changes or surgery as treatment options.[1]
Physical therapy or surgery?
Most people start with physical therapy and activity changes. Three randomized trials have compared surgery with structured physical therapy.
The research in detail: What the trials found
In the UK FASHIoN trial of 348 people, both groups improved, but hip arthroscopy led to better hip-related quality of life at 12 months than a personalized physiotherapy program. The difference was modest but large enough to matter to patients.[2]
The UK FAIT trial of 222 people found arthroscopy gave better daily-function scores at eight months than physiotherapy and activity changes.[3]
A smaller US trial of 80 mostly military patients found no difference between surgery and physical therapy at two years, though many in the therapy group crossed over to surgery.[4]
An Australian trial found surgery improved symptoms more than physiotherapy at 12 months, but MRI measures of cartilage health were no better after surgery.[5] Whether reshaping the hip prevents arthritis later is still unknown.
If you choose therapy first, ask what a good trial looks like (how many sessions, over how long) and what would make surgery the next step.
Who tends to do well, and who doesn't
Surgery tends to suit people with clear FAI syndrome, symptoms that limit activity, and little or no arthritis.[1]
Outcomes are much less predictable when arthritis is already present. A systematic review of hip arthroscopy in hips with moderate arthritis found conflicting results, with some studies reporting that 35% to 70% of hips went on to hip replacement.[7] If you have arthritis on X-ray, ask your surgeon how that changes their recommendation.
Hip dysplasia, where the socket is too shallow, is a different problem. Arthroscopy alone may not address it, and some people need an open operation to reorient the socket instead.
Several studies have found differences in results between men and women, but the evidence is mixed. In one review, about a third of studies found women had worse outcomes, while most found no difference.[8] A 2025 meta-analysis found women were less likely than men to return to the same level of sport.[10]
What happens during surgery
Hip arthroscopy is done under general or regional anesthesia, usually as an outpatient.[13][14] Your leg is put in traction to open a small gap in the joint. The surgeon works through two or three small incisions with a camera and instruments.
- Bone reshaping: shaving the cam bump and/or trimming the socket rim.
- Labrum: repairing it back to the bone with small anchors, or trimming damaged tissue. In a small randomized trial in women, repair gave better function than trimming.[11]
- Capsule: many surgeons close the joint capsule at the end to help stability.
The operation typically takes one to two hours.
Recovery
- Weeks 0 to 2Crutches with partial weight-bearing, sometimes a brace. Stationary bike with no resistance and gentle movement as your plan allows.
- Weeks 2 to 6Gradually off crutches. Physical therapy focuses on motion and core and hip strength.
- Months 2 to 4Progressive strengthening. Most people with desk jobs are back at work. Low-impact exercise.
- Months 4 to 9Running and sport-specific training. In a review of 35 studies, athletes returned to sport at about 7 months on average, and about 74% returned to their pre-injury level.[9]
Risks and complications
A review of 92 studies with more than 6,000 patients found:[6]
- Major complications in about 0.6%, such as blood clots, infection or fracture.
- Minor complications in about 7.5%, most often temporary numbness from traction on the nerves (usually around the groin or foot), or cartilage scuffing during the procedure.
- Reoperation in about 6% at an average of 16 months, most often conversion to hip replacement (about 3%).
The authors noted that minor complications and reoperation are linked to the surgeon's learning curve, so experience matters.[6] Other risks include hip instability if the capsule doesn't heal, and stiffness or scar tissue.
Questions to ask your surgeon
- Do I have FAI syndrome, or just an unusual hip shape on X-ray?
Why we ask: Many people without hip pain have cam or pincer shapes. The diagnosis needs symptoms, exam findings and imaging together. What femoroacetabular impingement is
- Have I tried enough physical therapy? What would a good trial look like?
Why we ask: Both surgery and structured physiotherapy improved symptoms in trials. Surgery did somewhat better at 8 to 12 months in two UK trials. Physical therapy or surgery?
- How much arthritis is in my hip, and how does that change your recommendation?
Why we ask: Results are unpredictable once moderate arthritis is present, and many hips go on to replacement. Who tends to do well
- Do I have any hip dysplasia?
Why we ask: A shallow socket is a different problem, and arthroscopy alone may not fix it. Who tends to do well
- Will you repair or trim my labrum, and will you close the capsule?
Why we ask: In a small trial in women, labral repair gave better function than trimming. What happens during surgery
- How many hip arthroscopies do you do each year?
Why we ask: Complications and reoperations are linked to the surgeon's learning curve. Risks and complications
- How long will I be on crutches, and when can I return to work and sport?
Why we ask: Athletes returned to sport at about seven months on average, and about 3 in 4 got back to their previous level. Recovery
- What results do you see in patients like me, especially my age and sex?
Why we ask: Some studies found women were less likely to return to the same level of sport. Your surgeon's own results are useful context. Who tends to do well
Print this page or save it to your phone, and write down the answers during your visit.
Understanding your implant options
The companies that make the implants and devices used in this surgery, compared side by side with FDA records and sources, plus recent research and FDA news explained for patients.
Recovery supplies
We list recovery supplies at every budget, from gel ice wraps to cold therapy machines, with what to look for in each.
- Crutches and getting around
- Cold therapy and swelling
- Getting around at home
- Exercise at home
- Bathroom safety
Sources
- Griffin DR, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016;50:1169-76. https://pubmed.ncbi.nlm.nih.gov/27629403/
- Griffin DR, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018;391:2225-35. https://doi.org/10.1016/S0140-6736(18)31202-9
- Palmer AJR, 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. https://doi.org/10.1136/bmj.l185
- Mansell NS, et al. Arthroscopic surgery or physical therapy for patients with femoroacetabular impingement syndrome: a randomized controlled trial with 2-year follow-up. Am J Sports Med. 2018;46:1306-14. https://doi.org/10.1177/0363546517751912
- Hunter DJ, 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;22:697. https://doi.org/10.1186/s12891-021-04576-z
- Harris JD, et al. Complications and reoperations during and after hip arthroscopy: a systematic review of 92 studies and more than 6,000 patients. Arthroscopy. 2013;29:589-95. https://doi.org/10.1016/j.arthro.2012.11.003
- Andronic O, et al. Inconclusive and contradictory evidence for outcomes after hip arthroscopy in patients with femoroacetabular impingement and osteoarthritis of Tönnis grade 2 or greater: a systematic review. Arthroscopy. 2022;38:2307-18. https://doi.org/10.1016/j.arthro.2022.01.024
- McCormack TJ, et al. Sex-based differences in outcomes after hip arthroscopic surgery for femoroacetabular impingement: a systematic review. Orthop J Sports Med. 2022;10:23259671221137857. https://doi.org/10.1177/23259671221137857
- Reiman MP, et al. Femoroacetabular impingement surgery allows 74% of athletes to return to the same competitive level of sports participation but their level of performance remains unreported: a systematic review with meta-analysis. Br J Sports Med. 2018;52:972-81. https://doi.org/10.1136/bjsports-2017-098696
- King MG, et al. Are women less likely to return to sport compared to men following hip arthroscopy? A systematic review and meta-analysis. J Orthop Sports Phys Ther. 2025;55(3):1-13. https://doi.org/10.2519/jospt.2025.12813
- Krych AJ, et al. Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement: a prospective randomized study. Arthroscopy. 2013;29:46-53. https://doi.org/10.1016/j.arthro.2012.07.011
- OrthoInfo (AAOS). Femoroacetabular impingement. https://orthoinfo.aaos.org/en/diseases--conditions/femoroacetabular-impingement/
- OrthoInfo (AAOS). Hip arthroscopy. https://orthoinfo.aaos.org/en/treatment/hip-arthroscopy/
- MedlinePlus (US National Library of Medicine). Hip pain. https://medlineplus.gov/ency/article/003179.htm
- MedlinePlus (US National Library of Medicine). Hip injuries and disorders. https://medlineplus.gov/hipinjuriesanddisorders.html
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