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Hip Arthroscopy

Introduction to Hip Arthroscopy

Hip arthroscopy is a highly effective and minimally invasive surgical procedure that provides a clear view of your hip joint, helping to diagnose and treat various issues both inside and outside the joint.

During the procedure, a small fibre-optic instrument called an arthroscope is inserted into the joint. The arthroscope is equipped with a camera, which allows the surgeon to visualise the internal structures of the hip. The images captured by the camera are displayed on a TV monitor, enabling the medical team to carefully evaluate and address the specific issues present.

Please find below more detailed information on the hip arthroscopy procedure, including what to expect prior to, during, and after the surgery, as well as information on the recovery period.

Hip Arthroscopy Indications and Contraindications

Hip Arthroscopy Indications

Hip arthroscopy is recommended for patients experiencing persistent hip pain that has not responded to nonsurgical treatment. The procedure is used to relieve painful symptoms that result from damage to the labrum, articular cartilage, or other soft tissues surrounding the joint.

Some common indications for hip arthroscopy include:

  • Debridement of loose bodies: Removal of bone chips or torn cartilage debris causing hip pain and reduced range of motion.
  • Assessing and fixing the condition of the damaged cartilage or fragments in the joint.
  • Debridement of joint surfaces: Addressing conditions like mild arthritis that lead to the breakdown of tissue or bone within the joint.
  • Removal of adhesions: Addressing areas of scar tissue that limit movement and cause pain.
  • Synovial biopsy: taking a fragment of swollen tissue lining the hip for further evaluation.
  • Removal of bone spurs: Treating extra bone growth caused by injury or arthritis, which can damage the ends of the bones and limit joint mobility.
  • Evaluating and treating hip joint infections (septic arthritis).
  • Repair of torn labrum: Fixing tears in the labrum, the tissue lining the outer edge of the acetabulum (hip socket), ensuring a good fit with the femoral head (the hip joint’s “ball”).
  • Repair after trauma: Hip arthroscopy can be used to repair fractures or torn ligaments caused by traumatic injuries.
  • Partial Synovectomy: Removal of portions of the inflamed synovium (joint lining) in patients with inflammatory arthritis to alleviate pain. However, if the damage is more severe and requires a complete synovectomy, this will need to be done with an open, larger hip incision.
  • Evaluation and diagnosis: Patients with unexplained pain, swelling, stiffness, and instability in the hip that is unresponsive to nonsurgical or conservative treatment may undergo hip arthroscopy for further evaluation and diagnosis of the condition.

Hip Arthroscopy Contraindications

Arthroscopic debridement treatment is not advised if you have any of the following conditions:

  • Advanced hip arthritis.
  • Acetabular protrusion.
  • Hip ankylosis.
  • Skin lesions at portal sites.

Benefits and Risks of Hip Arthroscopy​


  • Offers precise assessment and treatment for conditions like labral tears and chondral damage that can’t be reliably diagnosed with radiographic studies.
  • Leads to less pain and stiffness after surgery compared to traditional open procedures with larger incisions.
  • Enables a quicker return to daily activities and a faster overall recovery compared to open surgery.


As with any surgical procedure, there are potential risks and complications, although they are relatively uncommon. Possible complications following hip arthroscopy can include:

  • A rare occurrence of permanent damage to the lateral femoral cutaneous nerve, affecting about 2% of patients.
  • Inadvertent chondral damage (damage to cartilage).
  • Infection in the skin or deep in the hip, which occurs in less than 1% of patients.
  • Vascular injury, resulting in excess bleeding.
  • Nerve injury: the pudendal nerve may be damaged by the traction post. 
  • Ongoing pain, especially if there is significant arthritis.
  • Need of a secondary surgery, if arthroscopy does not provide sufficient pain relief.

Surgical Approach

Hip arthroscopy is a technically demanding procedure that requires in-depth knowledge and surgical expertise. A/Prof Munjed Al Muderis has extensive experience in this area, having developed a technique for hip arthroscopy that avoids the use of traction, the standard method under which hip arthroscopy is performed. This approach helps to prevent unnecessary complications and discomfort.

Hip Arthroscopy Pre-Surgery Information

The following is what can be expected before hip arthroscopy surgery:

  1. Patient Evaluation: A thorough assessment of the patient’s overall health, medical history, and orthopaedic condition. When necessary, your health might need optimisation and we may refer you to another specialist.
  2. Medications: Inform your healthcare provider about any medications you’re taking, as some may need to be adjusted before surgery. You should stop taking aspirin or anti-inflammatory medications 10 days prior to the surgery. Also, you should discontinue any naturopathic or herbal medications during this period.
  3. Imaging: X-rays, CT scans, and MRIs are used to evaluate the extent of damage and plan the surgery. CT scans are especially helpful in planning the surgical steps.  
  4. Skin preparation: The night before and on the morning of the operation, you will be asked to wash the leg with a sponge provided at the pre-admission clinic. If there is any suspicion of an iodine allergy, a Betadine Skin test might be used.
  5. Bowel Prep: Glycerin suppositories will be provided at the pre-admission clinic, and you will need to administer them the evening prior to the surgery. An instruction leaflet will be given to guide them.
  6. Patient education: During a physiotherapy assessment, a qualified physical therapist will provide you with personalised instructions on gait training, the use of crutches, and pre- and postoperative exercises. You will be fitted with crutches to take home and practise before the surgery.

On the day of the Surgery

  • Surgical paperwork will be administered by the nurses, and the anaesthetist will meet with the patient to ask a few questions.
  • A hospital gown will be given, and the operation site will be shaved and cleaned.
  • Betadine skin prep will be applied to the area above the operation site and wrapped.
  • All x-rays are to be sent with the patient to the theatre.

Hip Arthroscopy Surgical Procedure

The following is what can be expected during hip arthroscopy surgery:

The procedure is performed under general anaesthesia or spinal anaesthesia.

A small incision will be made in the skin for the arthroscope, through which the inside of the hip and its damage can be identified.

X-ray control, facilitated by an image intensifier, is used to access the joint.

Fluid is pumped into the joint through the arthroscope to maintain a clear view and control any bleeding.

What the surgeon sees within the hip joint is projected onto a screen, allowing them to assess the joint thoroughly and decide on the appropriate treatment.

Once the cause of pain is established, two or three small incisions (portals) are made just above the bony prominence of the hip. Through these incisions, instruments are inserted which allow for precise tasks like shaving, cutting, grasping, passing sutures (stitches), and trying knots. These instruments allow for a range of procedures to be done, including smoothing off torn cartilage, trimming bone spurs, and removing inflamed tissue.

Following the procedure, local anaesthetic is injected into the hip and wound.

Upon completion, the arthroscopic incisions are usually sutured and then bandaged with adhesive tapes, and the hip is dressed with protective dressings. Depending on the surgeon’s findings and the extent of repair needed, the duration of the procedure may vary.

Hip Arthroscopy Post-Surgery Information

Following hip arthroscopy surgery, patients can expect the following:

Dressings: The incisions will be closed with absorbable cosmetic sutures and covered by a waterproof dressing. These dressings will remain intact for 7-10 days and will be changed by a nurse during the first post-operative review. It is essential to keep the wounds dry. Showering is advisable, using warm water and soap gently on the wound, and then drying the area very well.

Pain and swelling: The hip and groin area may be painful, and each patient may experience different levels of discomfort, but there should not be any severe pain. The patient will be prescribed analgesia (pain relief medication) and anti-inflammatory medication upon discharge from the hospital. It’s important to take these medications as prescribed and not wait for the pain to become severe. Some numbness in the groin or thigh due to position during surgery is normal and should resolve during recovery. Ice therapy around the incisions and groin (a maximum of 15 minutes per hour) during the first week will help with the inflammation. After one week, it’s best to keep the wound warm.

Mobilising: Once patients recover from anaesthesia, they will be mobile, ability to bear weight will be guided by the extent of repairs performed. Even if full weight-bearing is possible, crutches may be needed initially for support and safety. Some limping is expected for the first few weeks, but patients will notice a significant improvement in their gait over time.

Exercise: Patients can begin gentle exercise within a few days of surgery. Hydrotherapy can commence after the wounds have been checked. Non-impact exercises with a physiotherapist can start within 7-10 days. Patients should avoid deep flexion of the hip and use an exercise bike with the seat raised high. Physiotherapy will help improve the range of motion, proprioception, strength, control, and stability of the hip.

Exercise precautions: Patients should avoid deep flexion and any impact activities, such as running, for at least six weeks.


If patients are worried about their level of pain, experience significant bleeding, or notice fever or redness around the surgical site, they should contact the office immediately. If assistance is needed after hours, patients can contact the hospital where the surgery was performed, and they will contact Professor Al Muderis on their behalf.

Norwest Private Hospital(02) 8882 8882

Macquarie University Hospital: (02) 9812 3000

This treatment could be eligible for our No 'Out-of-Pocket' Expenses Program

For further information, click here or to check your eligibility, please contact our team.