What is hip arthroscopy.
Hip arthroscopy is keyhole surgery to repair the inside of the hip joint without opening it. Two or three small incisions, a fiber-optic camera, and specialized instruments — all working inside a joint deeper than the shoulder or knee, in a space less than a centimeter wide.
The procedure has only been widely practiced for about twenty years. Even now, most general orthopedists don't perform it. The learning curve is steep, the anatomy is unforgiving, and a poor result can mean accelerated hip arthritis. For those reasons, hip arthroscopy belongs to sports medicine sub-specialty practices — not to surgeons who do it occasionally.
Who it's for.
- Patients with hip impingement (femoroacetabular impingement / FAI) — extra bone causing pinching with deep flexion or rotation
- Patients with labral tears — the cartilage ring around the hip socket — confirmed on MRI and consistent with their symptoms
- Patients with focal cartilage damage in the hip not yet at the stage of arthritis
- Athletes with persistent groin or anterior hip pain after a thorough workup
- Patients told they need a hip replacement but want to explore preservation options first
How Dr. Pradhan approaches it.
Modern hip arthroscopy is as much about judgment as technique. We resect impinging bone precisely — too little and the impingement recurs, too much and the femoral head loses support. We repair the labrum whenever the tissue is salvageable; debridement is reserved for cases where the tear can't be saved.
The operation is performed with the patient in traction to open the hip joint. Care of the soft tissues around the joint — the iliopsoas tendon, the capsule, the surrounding nerves — matters as much as what we do inside it. We use the smallest portals possible (typically three) and a long-acting nerve block to keep early recovery comfortable.
Concurrent cartilage damage is addressed in the same operation when present, with the technique matched to the specific lesion — microfracture for small contained defects, more advanced cartilage work for larger or more complex injuries.
What recovery looks like.
Crutches for the first 1–2 weeks at partial weight bearing — this protects the labrum repair and gives the soft tissues time to settle. Physical therapy starts within days, with the first focus on protected range of motion and reactivating the deep hip stabilizers.
Most patients are off crutches by week 2 and off restrictions by week 6. Return to running typically begins at month 3; return to cutting or pivoting sports between months 4–6, gated on objective criteria rather than the calendar.
We work with a small group of trusted Dallas-area physical therapists who follow our hip arthroscopy protocols — including the early-phase motion targets, when to add resistance, and how to test for return-to-sport readiness.
Frequently asked.
How do I know if my hip pain needs arthroscopy or a different operation?
It's a combination of imaging and exam. Not every labral tear needs surgery; not every hip impingement is symptomatic. We look at the X-ray, the MRI, your specific symptoms, and how the joint behaves on exam — together, those tell us whether arthroscopy is the right tool.
What if I've been told I'm too old for hip arthroscopy?
Age alone isn't a contraindication. What matters is the cartilage status of the joint. A 60-year-old with preserved cartilage can be a good candidate; a 35-year-old with significant arthritis usually isn't. The imaging tells us.
Is hip arthroscopy outpatient surgery?
Yes, almost always. The operation takes 90–120 minutes under regional anesthesia and sedation. Most patients are home within a few hours.
What's the difference between hip arthroscopy and hip replacement?
They are different operations entirely. Hip arthroscopy preserves the native joint — it fixes problems inside the joint while keeping your own anatomy. Hip replacement removes the worn-out joint and replaces it with an implant. Arthroscopy is for earlier-stage problems; replacement is for end-stage arthritis.
How long is recovery, and when can I return to sport?
Crutches for 1–2 weeks, off restrictions by week 6, return to running around month 3, return to cutting sports at 4–6 months — gated on objective criteria, not the calendar.