A hip scope, formally called hip arthroscopy, is a minimally invasive surgery where a surgeon inserts a small camera and specialized instruments through a few small incisions around your hip joint. The camera transmits a magnified view of the joint’s interior, allowing the surgeon to identify and repair damage to cartilage, bone, and surrounding soft tissues without opening the joint fully. The procedure typically takes about 90 to 100 minutes and is performed as an outpatient surgery, meaning most people go home the same day.
Conditions a Hip Scope Can Treat
The most common reason for a hip scope is femoroacetabular impingement, often just called hip impingement. This happens when the ball and socket of your hip joint are shaped in a way that causes them to grind against each other during movement, creating pain and limiting your range of motion. During the scope, the surgeon shaves down the extra bone causing the friction.
Labral tears are the other major reason people end up in the operating room. The labrum is a ring of tough cartilage that lines the rim of your hip socket, acting like a gasket to keep the ball of your thighbone stable. When it tears, usually from impingement, injury, or repetitive motion, a surgeon can either repair it or trim the damaged portion. Hip scopes also address loose fragments floating inside the joint, tight tendons that need releasing, and tendons that have torn away from bone during an injury.
When a Hip Scope Won’t Help
Not everyone with hip pain is a good candidate. The procedure works best when the joint itself is still in relatively good shape. If you already have moderate to advanced arthritis, the results drop off significantly. A systematic review found that patients with more than mild arthritis on X-ray, or whose joint space has narrowed to 2 millimeters or less, are unlikely to benefit and are more likely to eventually need a full hip replacement anyway. Your doctor will typically check X-rays and sometimes an MRI to assess how much cartilage you have left before recommending a scope.
What Happens During Surgery
You’ll receive either general anesthesia (fully asleep) or a regional block that numbs you from the waist down. Once you’re under, the surgical team positions your leg in a traction device that gently pulls the ball of your thighbone away from the socket, creating enough space for the instruments to fit inside the joint. This traction step is one of the more delicate parts of the procedure. Surgeons aim to keep traction time under two hours to minimize the risk of nerve irritation.
The surgeon then makes two or three small incisions, each roughly the width of a pencil, around the outside of your hip. Through one incision goes the arthroscope, a thin tube with a camera and light on the end. Through the others go the tools needed for the repair: tiny shavers, drills, or suture anchors depending on what needs to be fixed. The surgeon works while watching a high-definition monitor that shows the inside of your joint in real time, switching the camera between incisions to get different angles.
Labral Repair vs. Trimming
If you have a labral tear, your surgeon will decide during the procedure whether to repair the torn tissue or simply trim away the damaged portion. This distinction matters more than it might seem. A study tracking 204 patients for up to 10 years found that only 5% of those who had their labrum repaired eventually needed a hip replacement, compared to 22% of those who had the damaged tissue trimmed away. That’s a fourfold difference in long-term joint preservation.
In the short term, both approaches provide similar pain relief and patients report comparable satisfaction within the first six months. The gap shows up years later, when the labrum’s role as a stabilizer and shock absorber becomes more apparent. Repair involves stitching the torn tissue back to the bone using tiny anchors, so the recovery is a bit longer, but the tradeoff favors keeping as much of your original labrum as possible.
Recovery Timeline
You’ll leave the surgery center on crutches. How long you need them depends on what was done inside the joint. For simpler procedures like removing loose tissue, partial weight bearing typically lasts two weeks or less. If the surgeon repaired your labrum or reshaped bone, expect to use crutches for up to six weeks. The general rule is to stay on crutches until you can walk without any limp, even if that takes longer than the standard guideline suggests.
Physical therapy starts soon after surgery and follows a structured progression through four or five phases over roughly 7 to 24 weeks. The early phase focuses on controlling swelling, protecting the repair, and maintaining gentle range of motion. From there, you work toward walking normally without an assistive device, then rebuilding strength and endurance. The later phases introduce sport-specific movements and power training for people aiming to return to athletics. Return to sport generally falls somewhere between 7 and 32 weeks depending on the complexity of the surgery and the demands of the activity.
Risks and Complications
Hip arthroscopy is considered low-risk compared to open hip surgery, but it’s not without potential problems. The most studied complication is temporary nerve irritation caused by the traction device. One prospective study found that about 2% of patients experienced numbness in the groin or perineal area after surgery, with symptoms tied to how long traction was applied. All affected patients recovered fully, most within 6 to 9 weeks, and the patient with the longest traction time recovered by 12 weeks. Keeping traction time under about 30 minutes was associated with fewer nerve symptoms.
Other possible complications include stiffness, infection at the incision sites, and the formation of extra bone near the joint during healing. These are uncommon but worth knowing about so you can flag any unusual symptoms during your follow-up visits.
Long-Term Success Rates
For patients treated for hip impingement, a long-term follow-up study found that about 74% reported being satisfied or very satisfied with their results. Roughly 76% of patients needed no additional surgery or treatment after their initial scope. The return-to-sport rate was 85%, though only about 67% made it back to their pre-injury level of competition, a realistic number that reflects how demanding full athletic recovery can be.
About 21% of patients in that study eventually converted to a total hip replacement, on average about five years after the scope. This underscores why patient selection matters so much. A hip scope works best as a joint-preserving procedure for people whose cartilage is still largely intact. For those patients, it can provide years or even decades of improved function and reduced pain.