Hip preservation · London
Arthroscopic hip labral repair, by a hip preservation surgeon.
A day-case repair of the acetabular labrum with cam femoroplasty and rim trim for FAI, done by a named consultant with a dedicated hip preservation practice, in a CQC-registered London hospital, with open PAO and arthroplasty pathways if arthroscopy is not the right call.
Why patients choose us
- 01
A hip preservation surgeon, not a general orthopod
A named consultant with a dedicated hip arthroscopy practice, high FAI case volumes, and audited outcomes in iHOT-33 and HOS.
- 02
The right operation for the right hip
Not every symptomatic labrum wants arthroscopy. Borderline dysplasia with LCEA 20 to 25 degrees may need a periacetabular osteotomy, not a scope. We say so before you book.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private hip arthroscopy costs in London.
Indicative ranges across our partner units. Send your MRA and standing X-rays and we quote firm figures across two or three named-surgeon options.
In short
Arthroscopy with labral repair and cam femoroplasty in our London network: £12,500 to £18,500, home the same day.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Consultant hip preservation opinion (with imaging review) | £300 to £550 | 45 min | Same visit |
| MR arthrogram of the hip | £950 to £1,600 | 45 min | 48 hours |
| Diagnostic hip arthroscopy | £8,500 to £11,500 | 60 to 75 min | Same day |
| Hip arthroscopy with labral repair | £10,500 to £14,500 | 90 min | Same day |
| Arthroscopy with labral repair and cam femoroplasty | £12,500 to £18,500 | 90 to 120 min | Same day |
| Periacetabular osteotomy (PAO, dysplasia pathway) | £24,000 to £34,000 | 3 to 4 hours | 4 to 5 nights |
Prices vary by named surgeon, by hospital (Fortius Hip Preservation, London Hip Unit, HCA Wellington, Cromwell BUPA, RNOH Private, ISEH UCLH), by whether cam femoroplasty and rim trim are added, and by cartilage grade found at surgery. We come back with a firm quote within one working day.
The problem
The right surgeon, the right operation, the right hip.
A symptomatic labral tear booked onto a general orthopaedic list, without alpha-angle and LCEA planning, is how you get an under-resected cam, a debrided labrum and a hip that fails at 3 years. We stop that happening.
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Is arthroscopy the right operation?
A hip with LCEA under 25 degrees or Tönnis 3 to 4 arthritis is not a scope case. It is a PAO or an arthroplasty. We say so before you consent.
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Worried about outcomes and revision?
Under-resected cams and unrepaired capsules drive revision. Named surgeons, audited outcomes and iHOT-33 review are our default.
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Want it done in a specialist unit?
A named hip preservation consultant, a dedicated traction table, fluoroscopy, and physiotherapy that knows post-arthroscopy protocols.
The journey
From imaging to return to sport, what happens, in order.
One team from first message to 12-month iHOT-33 review, including physiotherapy and return to sport milestones.
Phase 1 · Before your surgery
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the hospital
Phase 3 · After
Rehab and return to sport
- 01
Before
You send us your MRA and X-rays
A short, confidential form. Standing AP pelvis, false-profile and Dunn views, plus MR arthrogram slices if you have them. Groin pain history and sport.
- 02
Before
We come back with a recommendation
Within one working day: whether hip arthroscopy fits, or whether PAO, resurfacing or arthroplasty is the honest call. Indicative price. Named surgeon options.
- 03
Before
We arrange the operation
Usually within two to four weeks. Prehab exercises, crutch fitting and anaesthetic screening are booked. Anticoagulants and NSAIDs reviewed.
- 04
On the day
Arrival at the hospital
Admission, consent, marking, and a chat with the anaesthetist. General anaesthetic with a regional block and traction on a specialist table.
- 05
On the day
The arthroscopy itself
1.5 to 2 hours. Anterolateral and midanterior portals, capsulotomy, labral repair with suture anchors, cam femoroplasty and rim trim, capsular closure.
- 06
On the day
Home the same day or overnight
A short recovery, crutch training and written aftercare. Most patients are home the same evening; a small minority stay one night.
- 07
After
Rehab and return to sport
Partial weight bearing for 2 to 3 weeks, brace for 2 weeks, physio from week 1. Running from 3 to 4 months. Sport at 4 to 6 months.
Typical end-to-end: 2 to 4 weeks to surgery. Running: 3 to 4 months. Sport: 4 to 6 months.
When it helps
When labral repair is the right step - and when it is not.
The hips we operate on most, plus the radiographic signs that mean arthroscopy is abandoned in favour of PAO or arthroplasty.
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C-sign groin pain with catching
A deep anterior groin pain the patient cups with a C-shaped hand, worse on sitting, twisting or getting out of a car, often with catching or clicking.
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Cam-type FAI, alpha angle over 55 degrees
A femoral head-neck bump seen on Dunn view or radial MRA slices, driving anterosuperior labral shear in flexion and internal rotation.
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Pincer FAI, acetabular overcoverage
Global overcoverage or focal crossover on standing AP films, with LCEA over 40 degrees, crushing the labrum against the femoral neck.
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Mixed cam and pincer, seen in 90 percent
Most symptomatic hips are mixed morphology. The plan addresses both sides of the joint at the same sitting.
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Athletes in hockey, dance, martial arts
Hip flexion and rotation loading sports. Also football, gymnastics and figure skating. Repeated end-range loading tears the labrum at the chondrolabral junction.
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Positive FADIR and FABER on examination
Flexion, adduction, internal rotation reproduces the groin pain. Positive FABER distance side to side supports the diagnosis alongside imaging.
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Tönnis 0 to 1 on standing X-rays
Preserved joint space with no or minimal osteophytes. Tönnis 2 is borderline. Tönnis 3 to 4 means arthroplasty, not arthroscopy.
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Red flag: dysplasia, LCEA under 25 degrees
A shallow acetabulum needs bony coverage, not just a labral stitch. Isolated arthroscopy in frank dysplasia risks accelerated failure. PAO is the honest referral.
Procedure options
Hip preservation is a family of operations - and PAO sits beside arthroscopy.
What each option on the table actually involves, and which fits which hip. For frank dysplasia (LCEA under 25 degrees), we refer to an open PAO surgeon rather than book a scope.
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Labral repair with suture anchors
Non-absorbable anchors placed on the acetabular rim, sutures passed around or through the labrum to restore the suction seal. Preferred over debridement where tissue quality allows.
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Labral reconstruction with graft
When the native labrum is irreparable or deficient, an iliotibial band or hamstring allograft is fashioned into a neo-labrum. Reserved for revision or complex primary cases.
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Cam femoroplasty (osteochondroplasty)
The head-neck bump is burred back under fluoroscopy to restore a normal alpha angle. Under-resection is the commonest revision reason; over-resection risks fracture.
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Acetabular rim trim for pincer
Focal or global over-hanging rim is burred back before the labrum is re-fixed to the new edge. Amount of resection is set by preoperative LCEA.
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T-capsulotomy and capsular closure
An interportal or T-shaped capsulotomy gives access to the cam. Anatomic closure or plication is essential, especially in borderline dysplasia and hyperlaxity.
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Labral debridement (selective)
A limited role: small, degenerate, unstable flaps in an older hip. Repair beats debridement for durability in the Uebelhoer and Philippon 5 to 10 year data.
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Periacetabular osteotomy (PAO)
Open reorientation of the acetabulum for dysplasia. Longer recovery, but the correct operation when LCEA is under 25 degrees rather than a scope alone.
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Second-opinion imaging review
A specialist review of your MRA, CT alpha angle, femoral version and standing films. Sometimes the answer is prehab and injection, not surgery.
Our vetted London network
A small panel of hip preservation surgeons, we picked them.
Consultants at Fortius Hip Preservation, the London Hip Unit, HCA Wellington, Cromwell BUPA, RNOH Private and ISEH at UCLH. Introductions are made privately, once we understand your hip.
Selection criteria
How we choose every hip surgeon in our network.
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Consultant hip preservation surgeons with high FAI case volumes, not occasional arthroscopists
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CQC-registered private hospitals with a specialist hip traction table and fluoroscopy
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Open PAO and arthroplasty pathways available when arthroscopy is not the right call
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Physiotherapy teams experienced in post-arthroscopy hip protocols and return to sport
Safety and recovery
What to expect afterwards - honestly.
Hip arthroscopy is a well-established preservation operation with satisfaction of 85 to 90 percent in the right hip. The things worth planning are traction time, HO prevention, rehab pace, and the 10 to 15 percent 10-year conversion to arthroplasty in borderline hips.
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General anaesthetic with regional block
Standard for hip arthroscopy. A femoral or lumbar plexus block reduces opioid use. You will not be able to drive for 24 hours after sedation.
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Traction pudendal neuropraxia
The commonest transient nerve issue, from perineal post pressure during traction. Usually a numb patch or transient sexual dysfunction that settles in weeks. Post-less tables help.
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Heterotopic ossification
Bone forming in soft tissue around the hip, more common after cam osteoplasty. Prevented with a short course of indomethacin or a single dose of radiotherapy in higher risk cases.
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Chondral injury during instrumentation
Iatrogenic scuffing of the femoral head can occur on portal entry. Careful capsulotomy and traction release minimise it. Discussed before you consent.
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Joint infection under 1 percent
Rare with prophylactic antibiotics and a clean day-case unit. Persistent hot, painful, swollen hip after week 1 needs urgent assessment.
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DVT and pulmonary embolism
Low but not zero. Mechanical prophylaxis, early mobilisation and chemoprophylaxis in higher risk patients. Calf pain or breathlessness needs same-day review.
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Capsular defect and instability
An unrepaired capsulotomy can leave a symptomatic capsular defect and microinstability, especially in borderline dysplasia. Anatomic closure or plication is our default.
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Adhesive capsulitis
Post-arthroscopy stiffness needing manipulation under anaesthesia in a small minority. Early physiotherapy and range-of-motion work reduce the risk.
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AVN of the femoral head
Rare, associated with aggressive rim resection or retinacular vessel injury. Careful surgical technique keeps the incidence well under 1 percent.
Reading your operation note
Your op note in four parts. Read the last one first.
Whichever surgeon operates, the note you receive keeps to the same shape.
A quiet reminder
Orthopaedic language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the op note before your six-week review, just ask.
- 01 Header
Side, diagnosis and morphology
Which hip, cam versus pincer versus mixed, alpha angle in degrees, LCEA, femoral version and Tönnis grade of joint space.
- 02 Technique
Portals, repair and osteoplasty
Anterolateral and midanterior portals, capsulotomy shape, anchor count and placement, cam and rim resection in millimetres, capsular closure.
- 03 Findings
Cartilage and stability grade
Outerbridge or ICRS grade of femoral and acetabular cartilage, chondrolabral junction integrity, capsular quality and any incidental findings.
- 04 Impression
Rehab plan and expected outcome
Read this first: partial weight bearing timeline, brace duration, physio milestones, running and sport return dates, and iHOT-33 review.
Recognised by major UK insurers
Cover for hip arthroscopy varies by insurer and by indication - usually funded when FAI and a labral tear are confirmed on imaging. We confirm cover before booking.
Frequently asked
Everything we get asked about hip labral repair.
Quick answers on FAI, dysplasia, rehab timelines, outcomes and cost.
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What is hip labral repair and when is it needed?
The labrum is a fibrocartilaginous ring around the acetabular rim that deepens the socket and creates a suction seal. Tears usually happen in the setting of femoroacetabular impingement (FAI), where a cam bump on the femoral head-neck or an over-covering acetabular rim shears the labrum in flexion and rotation. Repair is offered when there is groin pain with catching, imaging confirms a tear, and the joint is Tönnis 0 to 1 without established arthritis.
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What is FAI and how does it cause labral tears?
Femoroacetabular impingement is an abnormal contact between the femoral head-neck junction and the acetabular rim. Cam morphology (an alpha angle over 55 degrees, common in male athletes) shears the anterosuperior labrum in flexion. Pincer morphology (acetabular overcoverage, LCEA over 40 degrees) crushes the labrum. Around 90 percent of symptomatic hips are mixed cam and pincer. Sport in hockey, dance, martial arts and football raises the risk.
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How is the diagnosis made?
Examination uses the FADIR test (flexion, adduction, internal rotation reproducing groin pain) and FABER distance. MR arthrogram is the gold standard imaging for the labrum. Standing AP pelvis and false-profile X-rays give the Tönnis grade of arthritis, LCEA, and crossover sign for pincer. CT is used for alpha angle in three planes and femoral version. All four are needed before surgery is planned.
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What does the arthroscopy involve?
A general anaesthetic and hip traction on a specialist table, usually 1.5 to 2 hours. Two portals (anterolateral and midanterior), a capsulotomy for access, labral repair with suture anchors, burring of the cam bump (femoroplasty) and any acetabular rim trim, then capsular closure or plication. Suture anchor repair is preferred over debridement, with 5 to 10 year outcomes from Uebelhoer, Philippon and others supporting durability.
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What does the rehab and recovery look like?
Partial weight bearing on crutches for 2 to 3 weeks, hip brace for 2 weeks, physiotherapy from week 1. Stationary bike from week 2, pool work from week 4. Running from 3 to 4 months once strength and range are restored. Return to full sport at 4 to 6 months depending on discipline. iHOT-33 review at 6 and 12 months.
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What are the results and how much does it cost privately?
For Tönnis 0 to 1 hips, satisfaction is 85 to 90 percent with major iHOT-33 improvement. Borderline dysplasia (LCEA 20 to 25 degrees) needs careful selection because outcomes are less predictable, and 10 to 15 percent of hips convert to arthroplasty by 10 years. Frank dysplasia should have a PAO not a scope. Private cost is typically £12,500 to £18,500 for hip arthroscopy with labral repair and cam femoroplasty, inclusive of consultant, anaesthetist and hospital fees.
Ready to preserve your hip?
Send your MRA and standing X-rays. We will come back within a working day.
Two or three named hip preservation surgeons, firm fee quotes, and an honest answer on whether arthroscopy, PAO or arthroplasty is the right operation for your hip.
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