Hip preservation · UK
Private hip impingement (FAI) surgery, by a hip-preservation surgeon.
Arthroscopic cam and pincer osteoplasty with labral repair and capsular repair — for symptomatic femoroacetabular impingement that has not settled with physio. Warwick-consensus assessment, BHS-registered surgeons, honest advice.
Why patients choose us
- 01
A hip-preservation surgeon, not a generalist
FAI arthroscopy is a subspecialty. We introduce you to consultants who do this operation every week, in a BHS/BOA-registered unit.
- 02
The Warwick triad, honestly applied
Symptoms, exam and imaging must all point the same way. If they don’t, we say so — many hip pains are not FAI.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private FAI surgery costs in the UK.
Indicative ranges across our partner hip-preservation units. Send the details and we quote firm figures across two or three options — usually one central London and one out-of-town.
In short
Arthroscopic FAI surgery with labral repair in our network: £8,000–£12,000, home the same or next day.
| Procedure | Indicative range | Typical duration | Discharge |
|---|---|---|---|
| Hip arthroscopy — FAI osteoplasty + labral repair | £8,000–£12,000 | 1.5–2.5 hr GA | Same/next day home |
| FAI + labral reconstruction (graft) | £11,000–£14,000 | 2.5–3 hr GA | Overnight |
| Revision hip arthroscopy | £10,000–£14,000 | 2–3 hr GA | Same/next day |
| Diagnostic ultrasound-guided intra-articular injection | £450–£750 | 20–30 min | Same visit |
| MRI arthrogram of the hip | £650–£1,100 | 45–60 min | Report 24–48 hr |
| Hip-preservation consultation only | £250–£450 | 30–45 min | Same visit |
Prices vary by hospital, by the surgeon’s fee, by whether a labral reconstruction with graft is needed, and by whether an overnight stay is planned. Complex revision cases sit at the top of the range. NHS-funded care via a specialist hip-preservation unit is also possible for eligible patients.
The problem
The right diagnosis, the right surgeon, the right operation.
FAI is over-diagnosed on imaging and under-treated in practice. A bump on X-ray without symptoms is not a reason to operate. A dysplastic hip mis-labelled as FAI is a reason to avoid arthroscopy. We work through both before you commit.
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Not sure it is FAI?
The Warwick triad — symptoms, exam, imaging — must line up. Sometimes the diagnosis is a labral tear from dysplasia, or extra-articular. We say so.
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Tried physio and still stuck?
A structured 3–6 month hip-preservation programme is the reasonable first step. If it has not worked, arthroscopy is a fair next question.
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Want a hip-preservation specialist?
A named consultant who does FAI arthroscopy every week — not a generalist who does the odd case — in a BHS-registered unit.
The journey
From enquiry to return-to-sport — what happens, in order.
One surgeon and one physio team from first message to the day you go back to your sport.
Phase 1 · Before your operation
Assessment, imaging, physio trial
Phase 2 · On the day
Theatre and same/next day discharge
Phase 3 · After
Structured 4–6 month physio
- 01
Before
You tell us what is going on
A short, confidential form. Groin pain, sport, how long, prior imaging or physio.
- 02
Before
We come back with a recommendation
Within one working day: whether the picture fits FAI syndrome, the imaging to complete (Dunn X-ray, MRI arthrogram), and a suitable hip-preservation surgeon.
- 03
Before
Clinic and imaging review
Consultation, FADIR and FABER exam, imaging review together. A shared plan — physio, image-guided injection, or arthroscopic osteoplasty.
- 04
On the day
Arrival at the hospital
Admission, consent and a chat with the surgeon and anaesthetist. General anaesthetic with regional block.
- 05
On the day
The arthroscopy itself
1.5–2.5 hours in theatre. Traction on a fracture table under fluoroscopy, cam osteoplasty, labral repair with suture anchors, capsular repair.
- 06
On the day
Home the same or next day
Crutches, a hip-preservation protocol, and written aftercare. Most patients are discharged the same day; some stay one night.
- 07
After
Recovery and staged return
Partial weight-bearing 2–4 weeks, pool 2 weeks, cycling 4–6 weeks, running 3–4 months, professional sport 6–9 months. A structured 4–6 month physio programme.
Typical end-to-end: 3–4 weeks from enquiry to operation. Full recovery: 4–6 months.
When it helps
When FAI surgery is the right step.
The clinical and imaging pictures that make arthroscopic osteoplasty a reasonable option — plus the one that makes it the wrong operation entirely.
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Activity-related groin pain (C-sign)
A cupped hand around the front of the hip — classic FAI. Worse with deep flexion, squatting, or getting out of a low car.
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Cam morphology on Dunn X-ray
A bump at the femoral head-neck junction (alpha angle >55–60°) that jams into the socket at end-range flexion and internal rotation.
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Pincer over-coverage
A deep or retroverted acetabulum with a crossover sign — global or focal — that pinches the labrum on flexion.
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Anterosuperior labral tear
Confirmed on MRI arthrogram — the commonest location. Often with cartilage delamination on the acetabular rim.
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Mechanical catching and clicking
A deep, painful catch on rotation. Not the harmless snap of a snapping hip — this one hurts and limits sport.
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Younger active adult, 25–45
The typical FAI patient — runners, cyclists, footballers, dancers, martial artists. Sedentary lifestyles rarely present this way.
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Failed 3–6 months of physio
Structured hip mobility, core and gluteal work has not settled the pain — the point at which surgery is reasonably considered.
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Red flag: FAI + dysplasia
A shallow socket (low lateral centre-edge angle) mimics FAI but arthroscopy alone makes it worse. Needs peri-acetabular osteotomy (PAO), not this operation.
Procedure components
What actually gets done inside the hip.
FAI arthroscopy is not one operation but a set of components tailored to your hip. Here is what each one does — and where the boundary sits with a different operation entirely.
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Cam osteoplasty (femoral)
The femoral head-neck bump is reshaped with a high-speed burr under fluoroscopy — preserving labrum, cartilage and femoral-neck strength.
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Pincer rim resection (acetabular)
Focal or global over-coverage is trimmed at the acetabular rim, with the labrum taken down and reattached with suture anchors.
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Labral repair with suture anchors
Preferred to debridement — the labrum preserves the hip’s suction seal and joint mechanics. The current standard for tears that can be repaired.
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Labral reconstruction (graft)
For irreparable or ossified labral tears — reconstructed with ilio-tibial band or hamstring autograft. Reserved for severe deficiency.
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Capsular repair
Closing the capsulotomy at the end of the case is increasingly standard — reduces iatrogenic instability, especially after pincer work.
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Chondroplasty ± microfracture
For focal grade-IV cartilage defects on the acetabular rim — the defect is prepared and either stabilised or micro-fractured to encourage a repair tissue.
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Image-guided intra-articular injection
A diagnostic and therapeutic step before surgery — ultrasound-guided steroid + local anaesthetic tells you whether the pain really comes from inside the joint.
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Not FAI — PAO instead
If the underlying problem is dysplasia rather than impingement, a Ganz peri-acetabular osteotomy is the joint-preserving operation — not arthroscopy.
Our vetted UK network
A small panel of hip-preservation surgeons, we picked them.
Consultant hip-preservation surgeons in London and the major UK cities. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant hip-preservation surgeons registered with the British Hip Society (BHS/BOA)
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A dedicated FAI arthroscopy volume — the operation is done every week, not occasionally
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Warwick 2016 consensus applied honestly — triad of symptoms, signs and imaging
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Capsular repair as standard, and labral repair preferred to debridement
Safety and recovery
What to expect afterwards — honestly.
Well-selected FAI syndrome patients report 70–90% good or excellent outcomes at 5–10 years. Outcomes are worse with established osteoarthritis, age over 45, obesity, or dysplasia mistaken for FAI — and that is exactly why patient selection matters more than surgical technique.
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The Warwick triad matters
FAI syndrome requires all three: symptoms, clinical signs (FADIR positive) and imaging findings. Imaging alone — a bump on X-ray with no symptoms — is not a reason to operate.
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Traction-related neuropraxia
Traction on the fracture table can cause a temporary numb patch on the outer thigh (LFCN) or in the perineum (pudendal). Usually recovers in weeks; permanent injury is rare.
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Over- or under-resection
Under-resection of the cam leaves persistent symptoms; over-resection of the femoral neck raises stress-fracture risk. Both are why a high-volume surgeon matters.
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Iatrogenic instability
Aggressive pincer resection without capsular repair can leave a hip that feels unstable. Modern practice repairs the capsule to protect against this.
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Recovery is months, not weeks
A structured 4–6 month hip-preservation physio programme is part of the operation. Skipping it is the commonest cause of a disappointing result.
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Return-to-sport is staged
Pool 2 weeks, cycling 4–6 weeks, straight-line running 3–4 months, cutting sport 6–9 months. Professional athletes follow a supervised protocol.
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Heterotopic ossification
Small deposits of bone in the soft tissues can form after the operation. Anti-inflammatories for a short course afterwards reduce the risk.
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DVT, infection and other risks
Deep-vein thrombosis and pulmonary embolus are uncommon but real; infection is under 1%. Prophylaxis is standard and you are told the warning signs.
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Not everyone is a good candidate
Established osteoarthritis (Tönnis 2–3), age over 45, obesity, or unrecognised dysplasia predict a poorer result — sometimes a hip replacement, or PAO, is the honest answer.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever components were done, the note the surgeon sends you keeps to the same shape — and the physio plan sits at the bottom.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Diagnosis and morphology
Cam, pincer or mixed FAI; alpha angle; lateral centre-edge angle; Tönnis grade; labral tear location and cartilage status.
- 02 Technique
What was done inside the hip
Cam osteoplasty extent, pincer resection, labral repair or reconstruction with anchor count, capsular closure, any chondroplasty or microfracture.
- 03 Findings
Intra-operative photographs and video
Arthroscopic images before and after — the impingement, the labral tear, the repair. Kept on file and shared with your physio.
- 04 Impression
Weight-bearing, physio and return plan
Read this first: partial weight-bearing window, the specific physio protocol (repair vs microfracture), and the staged return-to-sport timeline.
Recognised by major UK insurers
FAI arthroscopy is usually covered by UK private medical insurance when the Warwick criteria are met and conservative treatment has failed. Pre-authorisation is confirmed before booking.
Frequently asked
Everything we get asked about FAI surgery.
Quick answers on diagnosis, cost, alternatives, recovery and long-term outcome.
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What is femoroacetabular impingement (FAI)?
FAI is a mismatch between the ball (femoral head) and socket (acetabulum) of the hip that causes them to pinch on movement. Cam-type has a bump on the femoral head-neck junction; pincer-type has an over-covering socket; most patients have a mixed picture. When the impingement causes symptoms, signs and matching imaging findings, it is called FAI syndrome (Warwick 2016 consensus).
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How do I know if my groin pain is actually FAI?
The Warwick triad has to be met: activity-related groin pain (often a C-sign), a positive clinical exam (FADIR test in particular), and imaging findings — a cam bump or pincer over-coverage on X-ray and a labral tear on MRI arthrogram. A diagnostic ultrasound-guided intra-articular injection can confirm the pain comes from inside the joint.
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Do I need surgery, or will physio fix it?
A structured 3–6 month course of hip-preservation physio — mobility, core, gluteal control — is the reasonable first step, alongside activity modification and sometimes an image-guided injection. If pain and mechanical symptoms persist despite that, arthroscopic osteoplasty is a reasonable next step for the right patient.
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What does the operation actually involve?
Under a general anaesthetic your leg is placed on a traction table under fluoroscopy. Through three small portals a camera and instruments enter the hip. The cam bump is reshaped, any pincer over-coverage trimmed, the labrum repaired with suture anchors (or reconstructed with a graft if irreparable), the capsule closed, and any cartilage defect treated. It typically takes 1.5–2.5 hours.
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How much does private FAI surgery cost in the UK?
Roughly £8,000–£12,000 for arthroscopic osteoplasty with labral repair, and £11,000–£14,000 if a labral reconstruction with graft is needed. This normally includes surgeon, anaesthetist, hospital, one night if required and follow-up. We confirm a firm figure across two or three options within one working day.
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How long is the recovery?
Partial weight-bearing on crutches for 2–4 weeks. Pool work at 2 weeks, cycling at 4–6 weeks, straight-line running at 3–4 months, and cutting or contact sport at 6–9 months. The physio protocol varies — a labral repair is more protective early on than a microfracture, which needs strict off-loading. Full recovery is a 4–6 month project.
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What are the risks?
The specific ones are traction-related pudendal or lateral-femoral-cutaneous neuropraxia (usually temporary), iatrogenic chondral injury, over- or under-resection of the cam, iatrogenic instability if the capsule is not repaired, heterotopic ossification, and re-tear of the labral repair. General surgical risks include DVT/PE and infection (under 1%).
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What are the chances I need a hip replacement later?
For a well-selected FAI-syndrome patient without pre-existing arthritis, 70–90% report good or excellent outcomes at 5–10 years. Around 5–15% go on to hip replacement over 5–10 years — the risk is higher with established osteoarthritis at the index operation, age over 45, obesity, or dysplasia mistaken for FAI.
Related treatments
Looking for something else?
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Hip arthroscopy
Wider hip arthroscopy — technique and indications beyond FAI.
Learn more -
Hip preservation surgery
Peri-acetabular osteotomy (PAO) for dysplasia and other joint-preserving options.
Learn more -
Hip physiotherapy
Structured hip-preservation physio — before and after surgery.
Learn more -
Hip injection treatment
Ultrasound-guided diagnostic and therapeutic intra-articular injection.
Learn more
Or browse every test and procedure we arrange.