Hip arthroscopy has emerged as a minimally invasive surgical technique for treating femoroacetabular impingement (FAI), demonstrating promising outcomes in appropriately selected patients. The surgical process involves patient positioning in either lateral or supine position, followed by the establishment of arthroscopic portals including anterolateral, anterior, and accessory portals. The procedure requires joint distraction using traction, followed by systematic diagnostic arthroscopy. Treatment includes labral pathology management through repair or debridement, osteoplasty of cam and/or pincer lesions, assessment of impingement-free range of motion, and capsular closure.
The recovery timeline spans several phases. During the first four weeks, patients undergo protected weight-bearing with crutches, range of motion restrictions to protect repaired tissue, and initial physical therapy focusing on pain control and gentle exercises. From weeks 4-8, patients progress to increased weight-bearing, expanded range of motion exercises, strengthening of core and hip musculature, and return to normal gait pattern. Weeks 8-12 involve advanced strengthening exercises, sport-specific training initiation, and gradual return to impact activities. The final phase, from 3-6 months, includes return to sport protocols, advanced agility training, and full activity resumption based on individual progress.
Clinical results show favorable outcomes, with short-term results (1-2 years) demonstrating 80-90% patient satisfaction rates, significant improvement in modified Harris Hip Scores, reduced pain scores, and improved range of motion. Mid-term results (2-5 years) show maintained functional improvements, high return-to-sport rates in athletic populations, and lower revision rates compared to open procedures.
Positive outcomes are associated with younger age (under 40 years), minimal arthritic changes, short duration of symptoms, proper surgical technique, and adherence to rehabilitation protocol. Reported complications include temporary nerve neurapraxia (0.5-1%), heterotopic ossification (1-3%), infection (less than 1%), DVT (less than 0.5%), and adhesions (0-3%).
Hip arthroscopy for FAI demonstrates reliable outcomes with appropriate patient selection and surgical technique. Success depends on careful attention to surgical details, structured rehabilitation, and patient compliance. Continued long-term studies will further define the durability of results and optimal patient selection criteria.
