Hip Procedures / Hip Arthroscopy


The hip joint is a ball and socket joint where ball of the thigh bone (femur) joins with the socket (acetabulum) of the pelvic bone. The ball is normally held in the socket by very powerful ligaments that form a complete sleeve around the joint (the joint capsule). The capsule has a delicate lining (the synovium). Until recently, any approach to the hip joint by surgeons involved a large incision, dislocation of the joint, a hospital stay of 7 days or longer, and the risk of exposing the joint to the ravages of arthritis in later years.

Arthroscopy is a technical term for keyhole surgery of a joint. Keyhole surgeries in other joints such as knee, shoulder, wrist and elbow have been well established. For some reason the hip has long been regarded as a difficult joint to arthroscope. In 1931, a researcher called Burman even said, "It is manifestly impossible to insert a straight needle between the head of the femur (ball of hip joint) and the acetabulum (hip socket)." Now, in the 21st century, keyhole hip surgery is here to stay, and, offers comprehensive access to an evolving series of conditions that affect the hip joint, many of which were previously unrecognised and, thus, left untreated.

Some common conditions that can be treated with hip arthroscopy are:

Arthritis. An arthritic hip joint can be cleaned using the arthroscope. Cleaning the joint offers pain relief in a bulk of patients and allows the surgeon to assess the joint, with a view to plan for a definitive surgery for the future.

Loose bodies. Loose bodies are small fragments of bone or cartilage that come adrift inside the joint, sometimes causing painful spasms and locking of hip movement. They can often be removed via the arthroscope.

Ligament and cartilage (labrum) tears. The hip contains a large ligament, a structure called “ligamentum teres”. Diagnosis of any pathology associated with this structure is extremely difficult without hip arthroscopy. Hip arthroscopy also allows us to visualise the cartilage of the hip joint called “labrum” which can easily be damaged during sport, or as a result of arthritis.

Synovitis. The lining membrane of the hip joint (synovium) can become inflamed and may occasionally need to be removed. This is easily performed arthroscopically.

Infection. The hip can become infected, just like many other joints of the body. Causes might include staphylococcus aureus, tuberculosis, and other organisms. Hip arthroscopy is an excellent way of establishing the true nature of the infecting organism so that appropriate antibiotic treatment can be commenced, as well as cleaning out the infection itself.

Fractures. Major injuries can sometimes cause the pelvis to fracture. This can result in small bone particles breaking loose within the hip joint, leading to loose bodies. These are best retrieved, hip arthroscopy being an excellent method of doing so.

Tumours. Very rarely it is possible for tumours to grow inside a hip joint. They can be identified and often removed using the arthroscope.

What to expect as a patient of Hip Arthroscopy

Admission on the day of operation
Further tests may be required on admission.
You will meet the nurses and answer some questions for the hospital records.
You will meet your anaesthetist, who will ask you a few questions.
The anaesthetist will discuss with you the type of anaesthetic. Anaesthesia is usually general.
You will be given hospital clothes to change into.
Approximately 15 minutes prior to surgery, you will be transferred to the operating theatre.


Hip arthroscopy is usually a day case operation and takes approximately 45 minutes to perform. Traction (pressure) is applied to the foot in order to distract the hip so that sufficient space can be made to enter the joint with the arthroscope. It is possible that during the procedure, one may find more pathology than the pre-operative diagnosis. Depending upon the arthroscopic findings, the procedures are performed. Particular attention is given to the pre-operative complaint.
Physiotherapists will advise on the post-operative protocol.
You are advised to remain non-weight bearing for four days after surgery to avoid damage to the soft articular cartilage as, the fluid is passed through the hip joint under high pressure to clear any debris during the procedure.
It is also important to avoid high impact activities in the first six weeks. First review will be in six weeks. It takes roughly three months to judge how effective the procedure has been.
Approximately 15 minutes prior to surgery, you will be transferred to the operating theatre.

General information

Hip arthroscopy is not widely available as it requires much specialist equipment and takes a long time to learn. The procedure carries, with it, a complication rate of approximately 5% and it is possible that some patients may not get benefit out of this surgery. However, the overall results and benefits of this procedure, performed by well-trained surgeons, far outweigh the risks.
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