Hip Arthroscopy in Sydney
Hip arthroscopy is keyhole surgery used to repair labral tears, treat impingement and address damage inside the hip joint. Smaller incisions mean less disruption to the joint and a rehabilitation plan that starts almost straight away.
What is hip arthroscopy?
Hip arthroscopy is keyhole surgery that allows the surgeon to look inside the hip joint and treat certain problems without making a large open incision. A small camera, called an arthroscope, is inserted through a small cut around the hip, and specialist instruments are used through other small portals.
It is commonly used to treat painful labral tears, femoroacetabular impingement, loose bodies, cartilage damage and selected causes of catching, locking or deep hip pain. It can also be used to help diagnose hip pain when symptoms and imaging suggest a problem inside the joint.
The hip is a deep, highly stable ball-and-socket joint, so hip arthroscopy is more technically demanding than knee or shoulder arthroscopy. The operation is most useful when the pain is coming from a treatable problem inside the joint, and when the hip does not already have advanced arthritis.
What is a hip labral tear?
The labrum is a ring of cartilage around the edge of the acetabulum, or hip socket. It helps create a suction seal around the femoral head, or ball, and contributes to hip stability, load sharing and smooth joint movement.
A labral tear can happen suddenly after an injury, such as a fall or twisting movement, or it can develop gradually over time. Many labral tears are linked to the shape and mechanics of the hip, especially femoroacetabular impingement, hip dysplasia, Perthes disease, previous trauma or early arthritis.
Importantly, a labral tear on MRI does not automatically mean it is the cause of pain. Research has found labral tears in many people with pain-free hips, so the imaging result needs to match your symptoms, physical examination and hip structure before treatment decisions are made.
Do you need hip arthroscopy?
Hip arthroscopy is not the first step for most people with hip pain. Many labral tears and impingement-related symptoms can improve with a structured non-surgical program, especially when the main drivers are strength, control, movement patterns or activity load.
You may be suitable for hip arthroscopy if you have persistent groin or front-of-hip pain, catching or mechanical symptoms, imaging that shows a treatable labral tear or impingement, and symptoms that have not improved with good rehabilitation and activity modification.
Not every labral tear needs surgery. Labral tears are common on scans, including in people without pain. The key question is not just whether a tear exists, but whether it is causing your symptoms and whether the underlying hip shape or mechanics can be improved without surgery first.
Hip arthroscopy is generally less helpful when there is established hip osteoarthritis, severe cartilage loss, major stiffness, significant dysplasia or pain mainly coming from the back, tendons, bursa, abdomen or another area. Your assessment is designed to work out where the pain is coming from before surgery is considered.
Symptoms of a labral tear
Many people with labral tears have no symptoms at all. When symptoms are present, they can vary from a deep ache to a sharp catching pain, usually felt in the groin or front of the hip.
Pain often worsens with activities that involve hip flexion, such as sitting for long periods, squatting, getting in and out of a car, putting on shoes and socks, or bending down. Some people describe clicking, catching, locking, giving way or a feeling that the hip is not moving smoothly.
When labral overload is related to dysplasia, or a shallow socket, symptoms may be felt more as deep pain on the outer side of the hip, especially with prolonged standing or walking.
What causes labral tears?
The labrum can be torn by a clear injury, such as a fall, twisting injury, sporting incident or sudden force through the hip. More commonly, the labrum is gradually overloaded because of the way the ball and socket move together.
Common causes and related conditions
- Femoroacetabular impingement (FAI): extra bone or shape mismatch can cause the femur and socket to pinch during hip movement
- Hip dysplasia: a shallow socket can overload the labrum because the hip has less bony coverage
- Hip osteoarthritis: cartilage wear and joint degeneration can be associated with labral tearing
- Perthes disease or childhood hip conditions: altered hip shape can increase labral stress later in life
- Trauma: falls, twisting injuries and contact sport can damage the labrum
- Repetitive loading: sport or work that involves repeated deep hip flexion, pivoting or squatting may contribute in some people
How are labral tears diagnosed?
Your MTP physiotherapist or doctor will begin with a detailed history and physical examination. They will ask where you feel pain, what brings it on, what settles it, whether there is clicking or catching, and how it affects work, sport and daily activities.
The physical examination looks at hip stiffness, movements that reproduce your symptoms, strength, symmetry, power production and movement control. The assessment also checks whether pain may be coming from outside the hip joint, such as the gluteal tendons, iliopsoas tendon, bursa, lumbar spine, knee or abdomen.
If a labral tear is suspected, MRI is commonly used to assess the labrum and other soft tissues. Specialised pelvis and hip X-rays are also important because they show the shape of the ball and socket, signs of impingement, dysplasia or arthritis, and whether hip preservation surgery is realistic.
In some cases, a local anaesthetic injection into the hip joint under imaging guidance can help clarify whether the pain is truly coming from inside the joint. This is useful because a labral tear may be present on MRI but not be the main pain generator.
Benefits and risks
What hip arthroscopy can help with
- Repairing or stabilising a symptomatic labral tear
- Treating femoroacetabular impingement by reshaping bone where appropriate
- Removing loose bodies or torn cartilage fragments that cause catching or locking
- Assessing and treating selected cartilage injuries
- Reducing mechanical symptoms in suitable patients
- Supporting return to sport or physical activity when the hip joint is otherwise healthy
- Using smaller incisions and less soft tissue disruption than open surgery
Risks to understand
- Common and temporary: bruising, swelling, stiffness, soreness and numbness or tingling related to traction or portals
- Uncommon: infection, blood clots, bleeding, wound problems and persistent pain
- Specific to hip arthroscopy: traction-related nerve irritation, heterotopic ossification, cartilage injury, labral re-tear, instability or stiffness
- Rare but serious: femoral neck fracture, avascular necrosis, major nerve or blood vessel injury
- Longer-term: symptoms may persist if pain is from arthritis, dysplasia, the spine or another source, and some patients may later need hip replacement
Hip arthroscopy can be very helpful in the right patient, but it is not a cure for advanced arthritis. The best results tend to occur when the joint cartilage is still healthy enough and the cause of the labral overload can be addressed.
Hip arthroscopy vs hip replacement
Hip arthroscopy is a hip preservation procedure. It aims to repair or stabilise damaged tissue and correct mechanical problems while keeping your own hip joint. It is usually considered for younger or more active patients with a treatable labral tear, impingement or loose body and without advanced arthritis.
Hip replacement is different. It replaces the damaged ball and socket surfaces and is usually more appropriate when arthritis is advanced and the joint surface is too worn for preservation surgery to work reliably.
| Hip arthroscopy | Hip replacement |
|---|---|
| Preserves the natural hip joint | Replaces the damaged joint surfaces |
| Used for labral tears, impingement, loose bodies and selected cartilage injuries | Used for advanced arthritis and severe joint surface damage |
| Performed through small keyhole incisions | Performed through a larger incision |
| Best when cartilage is still relatively healthy | Best when cartilage is too worn to preserve |
| Recovery focuses on hip control, range of motion and gradual loading | Recovery focuses on walking, strength and adapting to the new joint |
What are my treatment options?
The pain from a labral tear may improve with time, and non-surgical treatment should usually be explored first. The first stage often focuses on settling symptoms through relative rest, activity modification and short-term anti-inflammatory medication if it is safe for you.
Anti-inflammatory medications such as ibuprofen, diclofenac or meloxicam are not suitable for everyone, especially people with stomach, kidney, blood pressure, heart, asthma or blood-thinning concerns. Please check with your doctor or specialist before using them.
Non-surgical treatment
Once pain is under better control, the main focus is restoring strength, control, hip range of motion and movement mechanics. This is critical because many painful hips are overloaded by a combination of joint shape, weakness, poor control, training load or movement habits.
At MTP Health, our specialty hip program is designed to help you address the functional factors that can contribute to impingement and labral overload. This step is especially important if your goal is to return to sport, running, gym training or a physical job.
If pain persists, an image-guided injection of local anaesthetic and corticosteroid may be used to help settle inflammation inside the hip and clarify whether the joint is the source of pain.
Surgical treatment
If symptoms are severe, persistent and clearly linked to a treatable problem inside the hip joint, your surgeon may discuss surgery. The right operation depends on your age, symptoms, activity goals, hip shape, cartilage health and whether conditions such as dysplasia or arthritis are present.
In broad terms, surgical options may include hip arthroscopy, periacetabular osteotomy for selected cases of hip dysplasia, surgical hip dislocation for specific structural problems, or hip replacement when arthritis is too advanced for preservation surgery.
The procedure: what happens
Hip arthroscopy is usually performed under general anaesthesia. The leg is placed in a specialised boot and gentle traction is applied to create enough space inside the hip joint for safe access. X-ray guidance is often used during the procedure.
The surgeon makes two or three small incisions around the hip. A small camera is inserted into the joint, and sterile fluid is used to help expand the space and improve visibility. The camera displays the inside of the joint on a monitor so the surgeon can assess the labrum, cartilage, bone shape and other structures.
Depending on the findings, the surgeon may repair the labrum with small anchors, trim unstable tissue, remove loose bodies, reshape bone causing impingement, treat cartilage damage or address inflammation inside the joint. Once the procedure is complete, the instruments are removed and the incisions are closed and dressed.
After surgery
You will wake in the recovery room, where your pain, circulation and vital signs are monitored closely. Many patients go home the same day or stay one night, depending on the procedure performed, pain control, walking safety and medical needs.
You will usually use crutches after surgery. How long you need them depends on what was done inside the hip. Some patients use them mainly for comfort for a short period, while others need protected weight-bearing for longer if labral repair, cartilage work or bone reshaping was performed.
When to seek help. Contact us or seek urgent care if you develop a fever, increasing calf pain or swelling, spreading redness, wound discharge, shortness of breath, chest pain, new numbness or weakness, or pain that is not controlled by medication. Concerned about your recovery? Call (02) 9437 9794.
Hip arthroscopy recovery and rehabilitation
Recovery after hip arthroscopy depends on the exact procedure performed. Labral repair, bony reshaping for impingement and cartilage procedures all have different loading and rehabilitation requirements.
The early phase focuses on protecting the repair, settling pain and swelling, restoring comfortable movement and walking safely. As the hip settles, rehabilitation progresses into strength, control, balance, gait, running preparation and sport-specific loading where appropriate.
Recovery timeline
| Phase | Timeframe | What to expect |
|---|---|---|
| Protect & settle | Days 0–14 | Crutches as directed, wound care, pain control, gentle mobility and early activation exercises |
| Early movement | Weeks 2–6 | Gradual walking progression, range-of-motion work, early strength and avoiding deep hip flexion or loaded twisting |
| Strength & control | Weeks 6–12 | Progressive strengthening, balance, hip control, cycling and functional movement retraining |
| Return to running preparation | Months 3–4 | Higher-level strength, impact preparation and running progression if strength and symptoms allow |
| Return to sport | Months 4–6+ | Sport-specific loading, agility, change of direction and gradual return to higher-demand activity |
| Final recovery | Months 6–12 | Ongoing improvement in strength, confidence, endurance and hip control |
Timeframes are a guide. Your surgeon and rehabilitation team will progress you based on the procedure performed, your symptoms, your goals and your recovery.
Post-operative care
You will usually have small dressings over the arthroscopy portals. Keep the wounds clean and dry as directed. Bruising around the hip and upper thigh can occur and may take several weeks to settle.
Your surgeon may recommend anti-inflammatory medication for a short period after surgery to reduce the risk of heterotopic ossification, which is unwanted bone formation in the soft tissues. This is not suitable for everyone, so medication instructions are individualised.
Rehabilitation at MTP Health
This is where MTP Health is different. Your rehabilitation is delivered by our own physiotherapists and exercise physiologists, working in the same clinic as your surgeon. Your plan can begin before surgery and continue seamlessly afterwards, with everyone working from the same goals and shared clinical record.
Rehabilitation focuses on restoring movement early, then rebuilding hip strength, trunk control, walking quality, squatting mechanics, running readiness and sport-specific function. Your recovery may be supported by our post-operative rehabilitation, physiotherapy and exercise physiology services.
Returning to driving, work and sport
Return to driving depends on which hip was operated on, whether you drive an automatic or manual car, whether you are still using crutches, and whether you can safely perform an emergency stop. You must also be off strong painkillers. Please check with your surgeon and insurer before driving.
Desk-based work may be possible within one to two weeks for some patients, depending on pain, sitting tolerance, transport and medication use. More physical work takes longer and should be planned with your surgeon and rehabilitation team.
Return to sport is gradual. Low-impact activity such as stationary cycling is often introduced earlier, while running, kicking, pivoting, heavy lifting and contact sport usually require several months of progressive strengthening and movement retraining.
Rehab is half the result. Hip arthroscopy can repair or reshape structures inside the hip, but it does not automatically fix the movement patterns, strength deficits or training loads that may have contributed to symptoms. A clear rehabilitation plan is essential.
Hip arthroscopy cost in Sydney
The cost of hip arthroscopy depends on your private health cover, hospital insurance, surgeon fees, anaesthetist fees, assistant fees, hospital charges, imaging, implants such as labral anchors and any excess on your policy.
If you are having surgery using private health cover, your out-of-pocket costs depend on your insurer, level of cover and whether reduced-gap arrangements apply. The anaesthetist is an independent practitioner and may charge a separate gap, so we provide their details and recommend checking their quote before surgery.
The surgeons at MTP Health participate in various reduced-gap schemes run by different health insurance providers. Availability can vary, and reduced-gap surgical time slots may involve a longer wait. Your insurer may also charge an excess depending on your policy.
If surgery is performed through the public system, there is no out-of-pocket surgical cost, but waiting times can be long and depend on hospital access, urgency category and local availability.
Why have your hip arthroscopy at MTP Health
MTP Health brings together fellowship-trained orthopaedic surgeons, careful assessment, physiotherapy and exercise physiology in one clinic. That matters because hip arthroscopy is not just about repairing the labrum — it is about understanding why the labrum became painful and whether surgery is actually the right answer.
Honest advice comes first. If your hip is better suited to non-surgical care, we will tell you. If arthritis or dysplasia means arthroscopy is unlikely to help, we will explain why. If hip arthroscopy is suitable, we will help you understand the procedure, recovery, risks and expected outcome clearly before you decide.
Your surgeon
Dr Jonathan Negus
Dr Negus is a fellowship-trained hip and knee surgeon with a focus on hip preservation and joint replacement. He works alongside MTP Health's physiotherapy and exercise physiology team so your diagnosis, treatment and rehabilitation are managed as one plan.
View full profile →Frequently asked questions
What is a labral tear?
The labrum is a ring of cartilage along the edge of the acetabulum, or hip socket. It creates a suction seal around the femoral head, or ball, and helps with joint stability, load sharing and smooth hip movement.
A labral tear can happen suddenly after an acute injury, such as a fall or twisting incident, or it can develop slowly over time because the labrum is being overloaded.
Not every labral tear causes pain. Some tears are found on scans in people who have no hip symptoms, which is why diagnosis depends on matching the scan with your symptoms, physical examination and hip structure.
What causes labral tears?
The labrum can be torn by a hip injury, such as a fall, twist or sporting incident. It can also be gradually damaged by underlying hip conditions.
Common causes include femoroacetabular impingement, hip arthritis, dysplasia, Perthes disease, previous trauma and repetitive loading that involves deep hip flexion or pivoting.
Finding the cause matters because treating the tear alone may not be enough if the hip shape or movement pattern that caused the overload is still present.
What do I feel or notice with a labral tear?
Many patients with labral tears have no symptoms at all. Studies have shown that labral tears can be found in a large proportion of people with pain-free hips, and the percentage increases with age.
When pain is present, it may feel like a deep ache, sharp catching pain, clicking, locking or a pinching feeling in the groin or front of the hip. It often worsens with sitting, squatting, bending down, getting in and out of cars or putting on shoes and socks.
Patients with labral overload from dysplasia, or shallow hip sockets, may feel deep pain on the outer side of the hip, especially with prolonged standing or walking.
How are labral tears diagnosed?
Your MTP physiotherapist or doctor will start with a thorough assessment of your history, symptoms and hip function. They will examine your hip movement, stiffness, strength, symmetry and the movements that reproduce your pain.
If a labral tear is suspected, an MRI scan is commonly used to assess the labrum and other soft tissues. Specialised pelvis and hip X-rays are also important because they can show structural issues such as impingement, dysplasia or arthritis.
Hip pain can be complex. Pain may come from inside the joint, outside the joint, or be referred from the back, knee or abdomen. In some cases, an image-guided local anaesthetic injection may be used to help pinpoint the source of pain.
What are my treatment options?
The pain from a labral tear may improve with time, so non-surgical treatment should usually be explored first. Early care may include relative rest, activity modification and short-term anti-inflammatory medication if it is safe for you.
After symptoms settle, it is important to address strength, control, range of motion and movement mechanics. At MTP Health, our specialty hip program is designed to help improve hip function and reduce the functional contributors to impingement and labral overload.
If pain persists, a CT-guided or image-guided injection of local anaesthetic and corticosteroid may help settle inflammation and clarify the source of pain.
If symptoms remain severe or prolonged, your surgeon may discuss surgery. Options may include hip arthroscopy, periacetabular osteotomy, surgical hip dislocation or hip replacement, depending on your age, goals, hip shape, cartilage health and whether arthritis is present.
What happens during hip arthroscopy?
Hip arthroscopy is usually performed under general anaesthesia. The leg is placed in traction so the surgeon can safely access the joint.
Two or three small incisions are made around the hip. A camera is inserted into the joint, and specialist instruments are used to assess and treat the problem. This may include labral repair, bone reshaping for impingement, removing loose bodies or treating cartilage damage.
At the end of the procedure, the small incisions are closed and covered with dressings. Many patients go home the same day or stay one night, depending on what was done and how they recover from the anaesthetic.
What is recovery like after hip arthroscopy?
Recovery depends on the exact procedure performed. Some patients use crutches mainly for comfort for a short time, while others need protected weight-bearing for longer if a labral repair, cartilage procedure or bony reshaping was performed.
The first two weeks usually focus on wound care, pain control, gentle mobility and safe walking. Rehabilitation then progresses to strength, range of motion, balance, hip control and movement retraining.
Many people return to desk-based work within one to two weeks, but return to sport often takes several months. Full recovery can continue for six to 12 months, especially for higher-demand activity.
What are the risks of hip arthroscopy?
All surgery has risks. General risks include infection, bleeding, blood clots, wound problems and anaesthetic complications.
Specific risks of hip arthroscopy include traction-related nerve irritation, numbness or tingling, persistent pain, stiffness, heterotopic ossification, cartilage injury, labral re-tear and ongoing symptoms if the pain is coming from arthritis or another source.
Rare complications include femoral neck fracture, avascular necrosis, major nerve or blood vessel injury and the need for further surgery. Your surgeon will discuss your individual risk profile before surgery.
Is hip arthroscopy better than physiotherapy?
Not automatically. Many people with labral tears or impingement-related pain improve with a structured physiotherapy and exercise program, especially when the symptoms are driven by strength, control, mobility or activity load.
Hip arthroscopy may be considered when symptoms persist despite good non-surgical care and there is a clear mechanical problem that can be treated surgically.
Can a labral tear heal on its own?
The labrum has limited blood supply, so a structural tear may not fully heal in the same way as some other tissues. However, pain from a labral tear can improve, and many people return to activity without surgery.
Treatment focuses on reducing irritation, improving hip control, addressing impingement or overload factors, and deciding whether the tear is truly the main source of symptoms.
Hip arthroscopy consultations across Sydney
North Shore Health Hub, Level 4, Suite 401, 7 Westbourne St, St Leonards NSW 2065
St Leonards consulting →173 Warringah Road, Beacon Hill NSW 2100 — serving the Northern Beaches
Beacon Hill consulting →Also consulting at Gosford, Wahroonga, Castle Towers and Tamworth.
Talk to a surgeon about your hip
Book a consultation to find out whether hip arthroscopy is right for you — and if it is not, to leave with a clear plan for the most suitable next step.
Book a ConsultationPrefer to talk? Call (02) 9437 9794 · GP & physio referrals: referrer information
- Current peer-reviewed literature and consensus guidance on hip arthroscopy, labral tears, femoroacetabular impingement, dysplasia and hip preservation surgery.
- Evidence on asymptomatic hip labral tears and the importance of matching imaging findings with symptoms, examination and structural hip assessment.