Under traction, arthroscopic portals are established. The central compartment is assessed first — labral tears are repaired with suture anchors, chondral damage is addressed (microfracture or debridement), and the ligamentum teres is inspected and debrided if torn. The peripheral compartment is then assessed — cam morphology is corrected with osteochondroplasty, the capsule is managed (repair vs release), and any synovitis is debrided. Capsular closure is performed to prevent post-operative instability. The operation takes one and a half to two and a half hours.
Hip arthroscopy is recommended for athletes with confirmed intra-articular hip pathology causing groin pain during sport, who have not improved with at least three months of sport-specific rehabilitation and activity modification.
Hip-specific rehabilitation programme (adductor strengthening, hip flexor flexibility, core stability), activity modification, injection (diagnostic and therapeutic), and sport modification.
MRI arthrogram, X-rays including alpha angle assessment, diagnostic injection confirming intra-articular source. Pre-operative sport-specific assessment.
Return to sport in approximately 85–90% of athletes. Return to pre-injury level in approximately 70–80%. Best outcomes in patients with FAI morphology and labral tears without significant arthritis.
Traction-related numbnessCommon
Temporary perineal numbness. Usually resolves within hours.
Hip flexor irritationCommon
From portal placement. Temporary.
Residual symptomsUncommon
Not all athletes achieve complete symptom resolution.
LFCN injuryUncommon
Lateral femoral cutaneous nerve numbness. Risk 1–5%.
Capsular redundancyUncommon
If the capsule is not repaired, post-operative instability may develop.
HOUncommon
Heterotopic ossification. NSAIDs given prophylactically.
Femoral neck fractureRare
Very rare.
InfectionRare
Hip joint infection.
General anaesthesia with supine traction.
Crutches two to four weeks. Sport-specific rehabilitation programme over three to six months. Running at eight to twelve weeks. Non-contact training at three to four months. Full contact sport at four to six months. Elite athletes may return at three to four months with accelerated rehabilitation.
Reviews at two weeks, six weeks, and three months. Return to sport clearance assessment.
Which sports cause hip problems?
Sports involving repetitive hip flexion and rotation — football, hockey, martial arts, ballet, and running — are most commonly associated with FAI symptoms and labral tears.
Can I return to elite sport?
The majority of professional and elite athletes return to their previous level. Return rates are highest for FAI with labral repair in patients without arthritis.