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Halcy Orthopedics

Hip Arthroscopy in New York

Also known as: Arthroscopic Hip Surgery, Hip Scope, Hip Arthroscopic Surgery, Minimally Invasive Hip Surgery, Hip Joint Arthroscopy

4 min read
Reviewed by Dr. Maya Chen, MD, FAAOS

Dr. Maya Chen

Fellowship-trained orthopedic surgeonsacross two New York City offices

Hip preservation here starts before the operating room. A preoperative dynamic-imaging workup maps the femoroacetabular contact at the exact angle of pain, so the reshaping plan is patient-specific rather than textbook. Dr. Maya Chen has performed more than 450 hip arthroscopies, mostly on patients in their 20s through 40s with FAI and labral pathology, and the goal is always to keep the native joint rather than buy time toward replacement.

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Hip arthroscopy is a minimally invasive surgical procedure in which a small camera, called an arthroscope, is inserted into the hip joint through small portal incisions to diagnose and treat problems inside the joint. Working through the same small portals, the surgeon can repair a torn labrum, reshape bone in femoroacetabular impingement, remove loose bodies, treat certain cartilage defects, or address inflamed synovium. Because the hip is a deep, tightly constrained joint, the procedure requires specialized traction equipment and surgical expertise, but it spares the surrounding muscles compared with traditional open hip surgery and most patients go home the same day.

At a Glance

  • Hip arthroscopy uses a small camera and slim instruments to access the joint through portal incisions rather than the larger incision required for open hip surgery[1]
  • Reported major complication rates after hip arthroscopy are approximately 0.6 percent and minor complication rates approximately 7 percent in systematic reviews[4]
  • Long-term studies have reported survival without conversion to hip replacement of approximately 82 percent at 16 years in selected populations[5]

Overview

During hip arthroscopy, the surgeon positions the patient on a special traction table that gently distracts the femoral head from the acetabulum, creating space inside the joint. Sterile saline solution is then pumped in to further distend the joint capsule, allowing the arthroscope a clear view of the labrum, articular cartilage, ligamentum teres, and synovial lining.

Common procedures performed through the arthroscope include repair or reconstruction of a torn acetabular labrum, reshaping of the femoral head-neck junction (femoroplasty) and acetabular rim (acetabuloplasty) for femoroacetabular impingement, treatment of cartilage defects, removal of loose bodies, synovectomy, and treatment of selected ligamentum teres injuries.

Hip arthroscopy is typically performed as an outpatient procedure under general or regional anesthesia. The most established indication is symptomatic femoroacetabular impingement with associated labral pathology; randomized trials and large registry studies report meaningful improvement in pain and function in well-selected patients, though long-term conversion to hip replacement remains a consideration in older patients with pre-existing cartilage damage.

What to Expect During Treatment

  1. 1Preoperative evaluation, including history, physical examination, and imaging such as plain X-rays and MRI or MRI arthrogram to confirm the diagnosis and surgical plan
  2. 2General or regional anesthesia is administered and the patient is positioned on a traction table with appropriate padding and perineal protection
  3. 3The hip is gently distracted under fluoroscopy and the operative leg is prepped and draped in a sterile fashion
  4. 4The first portal is established laterally under fluoroscopic guidance and the arthroscope is introduced into the central compartment of the hip
  5. 5Additional working portals are placed under direct visualization, and a systematic diagnostic survey of the labrum, cartilage, and ligamentum teres is performed
  6. 6Targeted interventions are carried out, such as labral repair with suture anchors, femoroplasty, acetabuloplasty, microfracture, or removal of loose bodies
  7. 7Traction is released and the peripheral compartment is inspected; the capsule may be repaired or plicated as needed
  8. 8Portals are irrigated, instruments are withdrawn, and the small incisions are closed with sutures or adhesive strips and dressed with a sterile bandage

How does Hip Arthroscopy work?

  • The patient is positioned supine or lateral on a specialized traction table. Controlled distraction across the hip joint creates a small interval between the femoral head and acetabulum that is essential for introducing the arthroscope and instruments safely.
  • Two or three small portals, typically 5 to 8 millimeters each, are established around the hip under fluoroscopic guidance to avoid the sciatic, femoral, and lateral femoral cutaneous nerves. Sterile saline is pumped in to distend the joint capsule.
  • The arthroscope contains a fiber-optic light source and a small video camera. Live images of the labrum, articular cartilage, ligamentum teres, and synovium are projected onto a high-resolution monitor, allowing the surgeon to navigate the central and peripheral compartments of the hip.
  • Through additional portals, the surgeon introduces specialized hand instruments, suture anchors, burrs, and radiofrequency probes to repair the labrum, reshape the femoral head-neck junction, smooth the acetabular rim, or treat cartilage defects. Traction is released intermittently to protect the femoral head from prolonged distraction.

When It's Recommended

  • Femoroacetabular impingement (FAI) with persistent pain that has not responded to conservative care
  • Tears of the acetabular labrum, particularly tears associated with mechanical symptoms
  • Loose bodies of cartilage or bone within the hip joint
  • Focal articular cartilage defects amenable to debridement or microfracture
  • Synovial disease including hypertrophic synovitis or selected cases of pigmented villonodular synovitis
  • Ligamentum teres injuries with persistent symptoms
  • Snapping hip syndrome with internal mechanical causes
  • Septic arthritis of the hip requiring irrigation and debridement
  • Diagnostic evaluation when imaging is inconclusive but symptoms persist

Recovery & Aftercare

  • Most patients go home the same day, using crutches for 2 to 6 weeks depending on the procedure
  • Partial weight-bearing is typical for the first 1 to 2 weeks, with gradual progression to full weight-bearing under guidance
  • Mild to moderate groin and lateral hip discomfort, along with swelling, are common during the first 2 to 4 weeks
  • Physical therapy is commonly started within the first week and progresses through phases focused on motion, stabilization, strengthening, and return to sport
  • Return to desk work is often possible within 1 to 2 weeks; return to running and cutting sports generally takes 4 to 6 months
  • Full return to high-impact athletics may take 6 to 9 months and is guided by clinical and functional milestones
  • Persistent or worsening symptoms such as fever, increasing redness, severe pain unresponsive to medications, calf swelling, or shortness of breath warrant prompt medical evaluation

Alternative Treatments

  • Structured physical therapy emphasizing hip strengthening, motor control, and core stability
  • Activity modification, weight management, and avoidance of provocative positions
  • Nonsteroidal anti-inflammatory medications and other analgesics
  • Intra-articular corticosteroid or anesthetic injections, often under ultrasound or fluoroscopic guidance
  • Open hip surgery (surgical hip dislocation) for selected complex cases
  • Periacetabular osteotomy in patients with hip dysplasia
  • Total hip replacement for advanced osteoarthritis

Related Treatments

Cortisone InjectionPhysical Therapy

Frequently Asked Questions

Hip arthroscopy is a minimally invasive surgical procedure that uses a small camera, called an arthroscope, inserted through small portals to view and treat problems inside the hip joint. The surgeon can repair a torn labrum, reshape bone in femoroacetabular impingement, or remove loose bodies without the larger incision required for open hip surgery.
The procedure itself is performed under general or regional anesthesia, so patients do not feel pain during surgery. After surgery, groin and lateral hip soreness is typical for 2 to 4 weeks and is generally managed with ice, prescribed medications, and physical therapy. Crutches are used to protect the joint during early healing.
Hip arthroscopy is generally considered safe when performed by experienced surgeons. Systematic reviews report major complication rates around 0.6 percent and minor complication rates around 7 percent. See the safety section above for a detailed list of potential risks.
Most patients go home the same day and use crutches for 2 to 6 weeks. Many return to desk work within 1 to 2 weeks. Physical therapy progresses over several months, and return to running or cutting sports generally takes 4 to 6 months, with high-impact athletics taking up to 9 months.
Hip arthroscopy and hip replacement treat different problems. Arthroscopy addresses labral tears, impingement, and other soft-tissue or focal cartilage issues, typically in patients who still have good cartilage. Hip replacement is generally recommended for advanced osteoarthritis with significant joint space narrowing. A surgeon can help determine which procedure fits your specific diagnosis.
Contact your surgical team promptly if you develop fever, increasing redness or drainage at the incision sites, severe or worsening hip or groin pain unresponsive to your prescribed medications, calf swelling, shortness of breath, or chest pain. These can be signs of infection or a blood clot and warrant timely evaluation.
Hip Arthroscopy is commonly recommended for individuals experiencing femoroacetabular impingement (fai) with persistent pain that has not responded to conservative care, tears of the acetabular labrum, particularly tears associated with mechanical symptoms, loose bodies of cartilage or bone within the hip joint, focal articular cartilage defects amenable to debridement or microfracture. Schedule a consultation at Halcy Orthopedics in New York to find out if Hip Arthroscopy is right for you.
Hip Arthroscopy is available at our Manhattan Flagship office (401 Park Avenue South, Suite 800, New York, NY 10016); our Brooklyn Heights office (75 Henry Street, Suite 320, Brooklyn, NY 11201). Contact our office to schedule an appointment at the location most convenient for you.

Your Practitioner

Dr. Maya Chen, MD, FAAOS

Fellowship-trained orthopedic surgeon specializing in cartilage preservation and minimally-invasive joint procedures. Dr. Chen treats high-performance athletes and weekend warriors alike, with a focus on returning patients to the activities they love.

Dr. Marcus Rivera, MD

Fellowship-trained orthopedic spine surgeon focused on conservative-first care for sciatica and herniated discs. Dr. Rivera has performed more than 1,500 lumbar microdiscectomies and lectures internationally on minimally invasive spine surgery.

Dr. Priya Nair, MD

Non-operative sports medicine physician focused on regenerative orthopedic care. Dr. Nair leads the practice's PRP and ultrasound-guided injection programs, and serves as team physician for two NYC-area collegiate athletic departments.

Sources & References

This article draws from 5 sources, including peer-reviewed research, leading medical institutions.

Government & Research

Medical Institutions

Educational & General

Medically reviewed by Dr. Maya Chen, MD, FAAOS · Last reviewed: 2026-05-11