Groin pain in a younger adult, worse on sitting for long periods, driving, squatting or getting out of a car.
A C-sign — you cup the side of your hip with your hand when describing where it hurts.
Imaging showing femoroacetabular impingement (a cam or pincer shape) with a labral tear.
Clicking, catching or a sense of the hip locking briefly.
Symptoms that have persisted despite three to six months of proper physiotherapy.
It is probably not right if…
Established hip arthritis with narrowed joint space. Arthroscopy does not help an arthritic hip, and results are poor — a replacement or an osteotomy is the honest answer.
You have not yet completed a proper course of physiotherapy targeting the deep hip and core muscles.
The pain is coming from the back, the sacroiliac joint or a hernia rather than the hip itself.
Significant developmental dysplasia, where a socket-repositioning operation is the correct procedure rather than a keyhole one.
The pain that gets misdiagnosed for years
A young adult with groin pain that is worse after sitting, worse driving, and worse squatting is very often told it is a muscle strain, a hernia or a back problem. Many spend two or three years being treated for the wrong thing. The actual cause is frequently a subtle mismatch in the shape of the hip.
The hip is a ball in a deep socket. If the ball is not perfectly round where it meets the neck of the bone, or the socket rim is slightly too prominent, then bending the hip up pinches the two together. Between them sits the labrum — a rim of cartilage sealing the socket — and it takes the damage. That is femoroacetabular impingement, or FAI.
What the operation does
The hip is a deep joint held together by strong muscle, so it must be gently distracted to admit a camera. Two or three portals are made on the outside of the hip, and the work is done with live X-ray guidance alongside the arthroscopic view.
1
The joint is inspected
The camera assesses the labrum, the cartilage on both the ball and the socket, and the ligament in the centre of the joint. Damage is often more extensive than a scan suggested.
2
The labral tear is repaired
The torn rim is reattached to the socket edge with small anchors, restoring the suction seal that keeps the joint's fluid layer under pressure. Preserving and repairing the labrum, rather than trimming it away, is central to a lasting result.
3
The bone is reshaped
The prominence causing the pinch is shaved back to a normal contour — off the neck of the femur for a cam deformity, off the socket rim for a pincer. Enough to stop the impingement, not so much as to destabilise the joint.
4
Movement is tested
The hip is taken through full flexion and rotation under direct vision to confirm the pinch has actually gone. This is the step that validates the whole operation.
5
The capsule is closed
The joint capsule is repaired rather than left open, which protects against instability afterwards.
Who does well — and who does not
Patient selection is the single largest factor in the outcome of hip arthroscopy, more so than in almost any other joint. Done in the right hip it is a very satisfying operation; done in an arthritic hip it disappoints reliably.
Likely to do well
Unlikely to benefit
Under about 40
Over 50 with joint-space narrowing
Healthy cartilage on imaging
Established arthritis
Clear impingement shape and a labral tear
Diffuse pain without a structural cause
Symptoms reproduced on examination
Pain that does not fit the hip on testing
Committed to four to six months of rehabilitation
Expecting the operation alone to fix it
Normal socket coverage
Significant dysplasia — needs a different operation
Risks
Numbness in the groin, thigh or genital area from the traction needed to open the joint. Usually temporary, resolving over weeks.
Failure to relieve the pain, most often where arthritis was already present.
Progression to arthritis over the following years despite a technically successful operation.
Infection, in well under 1 in 100 cases.
A blood clot in the leg.
Fluid leaking into the surrounding tissues during surgery, which settles.
Rarely, a fracture of the reshaped neck of the femur, which is why reshaping is deliberately conservative.
Heterotopic bone forming in the soft tissues, usually preventable with anti-inflammatory medication afterwards.
What recovery actually looks like
Written as a plan, not a promise. Your own timeline will be adjusted to what is found during the operation and how you progress — but this is the shape of it.
Day 0–3
Home the next day
You will be up with crutches on the day of surgery. Some groin numbness is common and settles. Anti-inflammatory medication is started to reduce the chance of extra bone forming.
Walking with crutches
Partial weight through the leg
Gentle stationary cycling started early
Home on day one
Week 1–4
Movement without loading
Crutches for two to four weeks while the labral repair settles. Movement is encouraged from the outset — an immobile hip stiffens and scars quickly. Most people are back at a desk within two to three weeks.
Off crutches by four weeks
Stationary bike daily
Back to desk work
Driving from three to four weeks
Week 4–12
Strength and control
Deep hip and core strengthening, which is where the durable result comes from. Walking distance builds. Range of movement should be full and painless by around three months.
Normal walking pattern
Full pain-free range of movement
Progressive resistance work
Return to physical work
Month 3–6
Back to sport
Running is reintroduced when hip strength and control allow, followed by change of direction and sport-specific drills. Four to six months is typical for a return to competitive sport.
Running reintroduced
Change-of-direction drills
Sport-specific training
Cleared for competition
Patients who had this
Three years of 'groin strain' turned out to be a torn labrum
“I had physiotherapy for my groin, an ultrasound for a hernia and an MRI of my back. Nobody examined my hip. The pain was always worst after a long day at my desk and getting out of the car, which turned out to be the clue. The examination took about a minute and I finally had an answer.”
Priya S., 29 · Software engineer
Vesu · 11 months after treatment
Outcome. Hip arthroscopy with labral repair and reshaping of a cam deformity. Off crutches at three weeks, pain-free at desk work by two months, back to running at five months.
A consultation means your imaging on the screen, a plain explanation of what is actually wrong, and an honest opinion on whether you need surgery — including when the answer is no.