Specialist hip preservation · UK
Hip preservation surgery for young, active adults — by BHS fellowship-trained surgeons.
A joint-preserving hip operation done by the surgeon who does it every week — FAI, dysplasia, labral tear, cartilage lesion, early AVN or resurfacing — at a UK specialist centre, with the honest conversation about when a hip replacement is actually the better answer.
Why patients choose us
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A BHS fellowship-trained hip preservation surgeon
Not a generalist. A named surgeon whose weekly practice is joint-preserving hip surgery in young, active adults — the sort of case that belongs at a specialist centre.
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The full preservation spectrum, honestly weighed
From arthroscopy for impingement to peri-acetabular osteotomy for dysplasia — and the honest conversation about when a hip replacement is actually the better answer.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private hip preservation surgery costs in the UK.
Indicative ranges across BHS specialist centres. Send the details and we quote firm figures once the pathology and procedure are confirmed.
In short
Hip arthroscopy for FAI in our network: £8,000–£16,000, back to sport in four to six months.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Hip arthroscopy (FAI, labral repair) | £8,000–£16,000 | 90–120 min | 4–6 months rehab |
| Peri-acetabular osteotomy (Ganz PAO) | £16,000–£25,000 | 3–4 hrs | 6–12 months rehab |
| Surgical hip dislocation (Ganz SHD) | £15,000–£22,000 | 3–4 hrs | 6–12 months rehab |
| Hip resurfacing (BHR, Adept) | £12,000–£20,000 | 90–120 min | 3–6 months rehab |
| Proximal femoral osteotomy | £15,000–£25,000 | 2–3 hrs | 6–12 months rehab |
| Core decompression ± BMAC for AVN | £6,000–£12,000 | 45–60 min | 6 wk protected weight-bearing |
| Labral reconstruction (graft) | £10,000–£18,000 | 2–3 hrs | 4–6 months rehab |
| Consultation and imaging review | £250–£500 | 45 min | Written plan |
Prices vary by specialist centre, by the surgeon, by implant choice (BHR vs Adept for resurfacing, screw configuration for PAO), and by whether concomitant procedures are added. NHS-funded pathways go via referral to a specialist centre.
The problem
The right surgeon, the right pathology, the right procedure.
Young adults with hip pain get bounced between generalists — pain clinic, sports physio, arthroscopy list — and end up with a hip replacement they might have delayed by twenty years. We fix that referral, at a specialist centre, before the wrong operation is booked.
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Groin pain in a young adult?
FAI, dysplasia, labral tear or early AVN all need dedicated imaging and a fellowship-trained opinion — not a generic arthroscopy list.
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Told you need a hip replacement?
Under 50–55 with joint space preserved, preservation surgery may buy you twenty years. Worth asking before you commit to a THA.
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Want to return to sport?
Preservation surgery is judged on function, not just X-rays. We match you to a surgeon whose practice is built around getting active adults back to their sport.
The journey
From enquiry to rehabilitation — what happens, in order.
One clinician from first message to twelve-month review — with specialist hip preservation physio the whole way through.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A day-case or short admission
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Groin pain, C-sign, pivoting sports, family history of dysplasia, previous imaging — whatever you have.
- 02
Before
We come back with a recommendation
Within one working day: the right surgeon, the right specialist centre, whether you need repeat imaging (dedicated hip MRI arthrogram, standing pelvis X-ray, CT) before consultation, and indicative cost.
- 03
Before
We arrange the consultation
A dedicated hip preservation clinic — usually within two to three weeks. Imaging is reviewed, the pathology confirmed, and the joint-preservation options are set out honestly.
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On the day
Admission for surgery
Admission, consent, anaesthetic review, thromboprophylaxis planning. Procedure-specific set-up — traction table for arthroscopy, lateral position for osteotomy or resurfacing.
- 05
On the day
The operation itself
From 90-minute arthroscopic FAI correction to a four-hour open peri-acetabular osteotomy — the technique matches the pathology, done by the surgeon who does it every week.
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On the day
Ward, or home
Day-case for hip arthroscopy in many cases. One to four nights for osteotomy, resurfacing or open surgical hip dislocation. Physio starts on day one.
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After
Rehabilitation and review
Specialist hip preservation physio for four to twelve months depending on the procedure. Structured return to work, sport and load — reviewed at six weeks, three months, six months, one year.
Typical end-to-end: 2–3 weeks from enquiry to surgery. Full rehab: 4–12 months depending on procedure.
When it helps
When hip preservation surgery is the right step.
The pathologies we treat, the selection principles that make preservation work, and the one red flag that means a hip replacement is the honest answer.
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Femoroacetabular impingement (FAI)
Cam or pincer morphology causing groin pain, C-sign, pain on deep flexion. Arthroscopic cam osteoplasty, pincer resection, labral repair, capsular repair.
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Acetabular dysplasia in a young adult
Painful residual under-coverage of the femoral head in a hip with preserved joint space — peri-acetabular osteotomy can preserve the joint for 20 years or more.
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Irreparable labral tear
A labrum too damaged to repair — reconstruction with ITB, hamstring autograft or allograft, arthroscopic or via a safe surgical hip dislocation.
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Focal chondral defect
A discrete cartilage lesion — microfracture, scaffold, matrix-associated autologous chondrocyte implantation (off-label in hip) or particulated juvenile allograft.
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Avascular necrosis (Ficat 1–2)
Early AVN before femoral head collapse — fluoroscopy-guided core decompression, sometimes with bone graft or bone marrow aspirate concentrate, to delay a hip replacement.
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Post-SUFE or Perthes deformity
Residual femoral head or neck deformity from childhood slipped upper femoral epiphysis or Legg-Calve-Perthes — realignment osteotomy or safe surgical dislocation.
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Active young adult, preserved joint
Under 50–55, joint space above 2 mm, Tonnis grade 0–1, correctable pathology and a realistic goal of delaying — not avoiding — a future replacement.
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Red flag: hip already worn out
Widespread joint-space loss (Tonnis 3), gross deformity, fixed flexion, night pain at rest — preservation surgery will not save it. A total hip replacement is the honest answer.
Procedure options
The joint-preservation spectrum, explained.
What each option actually involves — and which pathology it fits. Dedicated pages linked for the procedures where the detail matters.
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Hip arthroscopy for FAI
Keyhole cam osteoplasty, pincer resection, labral repair and capsular closure — the workhorse of impingement surgery. See our dedicated pages on hip arthroscopy and hip impingement surgery.
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Labral reconstruction
For a labrum that cannot be repaired — ITB, hamstring autograft or allograft, done arthroscopically or via a safe surgical hip dislocation for extensive work.
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Peri-acetabular osteotomy (Ganz PAO)
Major open procedure for symptomatic hip dysplasia in a young adult — the acetabulum is cut free and re-oriented to cover the femoral head properly. Joint can be preserved 20 years or more.
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Surgical hip dislocation (Ganz SHD)
Trochanteric flip osteotomy allows the hip to be safely dislocated in theatre — the widest exposure for extensive intra-articular work, extra-articular FAI, PVNS or post-Perthes deformity.
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Femoral osteotomy
Varus, valgus or derotation osteotomy of the proximal femur — for congenital deformity, post-Perthes, post-septic arthritis or the residual capital deformity of a slipped upper femoral epiphysis.
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Chondral repair
Microfracture, scaffold, matrix-associated autologous chondrocyte implantation (NICE TA477 in knee, off-label in hip) or particulated juvenile allograft for a discrete cartilage defect.
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Hip resurfacing
Birmingham Hip Resurfacing or Adept — metal-on-metal implant that preserves femoral bone stock for the young, active adult male. Our dedicated hip resurfacing page has the detail.
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Core decompression for early AVN
Fluoroscopy-guided drilling of the femoral head, sometimes with bone graft or bone marrow aspirate concentrate — for Ficat 1–2 avascular necrosis, to delay collapse and replacement.
Our vetted UK network
A small panel of hip preservation surgeons, we picked them.
BHS fellowship-trained consultants at Oxford, Stanmore, Bournemouth, UCLH, Wrightington, Southampton, Sheffield, Cardiff and Newcastle. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every hip preservation surgeon in our network.
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Consultant orthopaedic surgeons with a British Hip Society hip preservation fellowship
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Practising at a recognised specialist centre — Nuffield Orthopaedic Centre Oxford, RNOH Stanmore, Royal Bournemouth, UCLH, Wrightington, Southampton, Sheffield, Cardiff or Newcastle
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Weekly PAO, hip arthroscopy or safe surgical dislocation practice — not an occasional case
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Access to specialist hip preservation physiotherapy for the full six to twelve months of rehabilitation
Safety and recovery
What to expect afterwards — honestly.
Hip preservation surgery is safe in the right hands, on the right patient. The things worth planning are patient selection, procedure-specific recovery, and the umbrella risks common to any major hip surgery.
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Patient selection is the whole game
Age under 50–55, Tonnis 0–1, joint space above 2 mm, correctable structural pathology, motivated for rehab. Preservation surgery in the wrong hip fails — and a hip replacement then follows anyway.
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Procedure-specific recovery
Arthroscopy is four to six months. PAO is six to twelve months with six weeks non-weight-bearing. Resurfacing is three to six months. Femoral osteotomy is six to twelve months.
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DVT and pulmonary embolism
Standard risk for any major hip surgery — chemical thromboprophylaxis for two to six weeks depending on procedure, calf pumps, and early mobilisation.
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Nerve neuropraxia
Lateral femoral cutaneous nerve and pudendal nerve (traction) for arthroscopy; sciatic and femoral nerve for peri-acetabular osteotomy. Usually temporary but a real risk worth naming.
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Osteotomy non-union
PAO, femoral osteotomy and trochanteric flip osteotomy can, rarely, fail to unite — needing revision or bone grafting. Smoking multiplies the risk substantially.
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Hardware pain and removal
Screws for PAO or plate and screws for femoral osteotomy can become symptomatic once the bone has healed. Removal is a smaller second procedure, usually after twelve months.
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Heterotopic ossification
Bone forming in the soft tissues around the hip — reduced with routine NSAID prophylaxis after open procedures.
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Conversion to hip replacement
The honest failure mode. Preservation delays a replacement; it does not guarantee you will never need one. Careful selection is why this matters so much.
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Red flags after surgery
Fever, spreading redness, worsening rather than easing pain, calf pain or breathlessness — all reasons to call the team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever preservation procedure was done, the note the surgeon sends you keeps to the same shape.
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 procedure chosen
The specific pathology — FAI cam + labral tear, dysplasia LCEA 18°, Ficat 2 AVN — and which preservation procedure was agreed with you.
- 02 Technique
Approach and intraoperative findings
Arthroscopic portals or open approach, what was seen at surgery (labral quality, cartilage status, cam morphology), and what was done.
- 03 Findings
Cartilage, labrum, fixation
Grade of any cartilage damage, whether the labrum was repaired or reconstructed, size and position of any implants or osteotomy fixation.
- 04 Impression
Weight-bearing, rehab, follow-up
Read this first: weight-bearing status, thromboprophylaxis duration, rehab milestones, return-to-sport timeline and when you will be reviewed.
Recognised by major UK insurers
Cover for hip preservation surgery varies by insurer and by procedure — usually funded when clearly medically indicated at a recognised specialist centre. NHS-funded pathways go via specialist centre referral. We confirm cover before booking.
Frequently asked
Everything we get asked about hip preservation surgery.
Quick answers on candidacy, cost, PAO, return to sport, and the honest failure modes.
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What is hip preservation surgery?
An umbrella term for joint-preserving hip surgery in young, active adults with correctable pathology — FAI, dysplasia, labral tear, focal cartilage lesion, early avascular necrosis, post-SUFE or Perthes deformity. The goal is to delay or prevent a total hip replacement, not to replace one.
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Am I a candidate for hip preservation rather than a hip replacement?
Broadly: under 50–55, joint space still above 2 mm, Tonnis grade 0 or 1 on X-ray, a correctable structural problem, and motivation for a long rehab. If the joint is already worn out, a hip replacement is the honest answer — and we will say so.
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What is a peri-acetabular osteotomy (PAO)?
Also called a Ganz osteotomy: a major open procedure for symptomatic hip dysplasia in a young adult. The acetabulum is cut free from the pelvis and re-oriented to properly cover the femoral head, then fixed with screws. Non-weight-bearing for six weeks and full rehab of six to twelve months, but it can preserve the native hip for twenty years or more.
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What does hip preservation surgery cost privately in the UK?
Roughly: £8,000–£16,000 for hip arthroscopy for FAI, £16,000–£25,000 for a PAO, £12,000–£20,000 for hip resurfacing, £15,000–£25,000 for a femoral osteotomy, and £6,000–£12,000 for core decompression. Firm figures are confirmed after consultation.
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Where in the UK is hip preservation surgery done?
It is a subspecialty of the British Hip Society, concentrated at specialist centres — Nuffield Orthopaedic Centre in Oxford, RNOH Stanmore, Royal Bournemouth, University College London, Wrightington, Southampton, Sheffield, Cardiff and Newcastle. NHS referrals go via a specialist centre; privately we introduce you directly to a fellowship-trained surgeon.
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Can I return to sport after hip preservation surgery?
Often yes — return to sport is a stated goal for most of our patients. Timescales depend on procedure: three to four months for arthroscopy, six months for resurfacing, nine to twelve months for PAO or femoral osteotomy. Pre-morbid demand and rehab compliance decide the ceiling.
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What are the alternatives to hip preservation surgery?
Activity modification, weight loss, structured physiotherapy, and image-guided hip injection (steroid, hyaluronic acid, sometimes PRP) — see our hip injection treatment page. A pericapsular nerve group (PENG) block can help pain in the interim. If the joint is already worn out, a total hip replacement is the right answer.
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What are the main risks?
DVT and pulmonary embolism, infection, temporary nerve neuropraxia (lateral femoral cutaneous or pudendal for arthroscopy, sciatic for PAO), non-union of an osteotomy, hardware pain and removal, heterotopic ossification, and conversion to a hip replacement — which is exactly why careful patient selection matters so much.
Related tests
Looking for something else?
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Hip arthroscopy
Keyhole surgery for FAI, labral tears and loose bodies.
Learn more -
Hip impingement surgery
Arthroscopic cam and pincer correction with labral repair.
Learn more -
Hip resurfacing surgery
Bone-preserving alternative for the young, active adult.
Learn more -
Hip replacement
When preservation is no longer the honest answer.
Learn more -
All tests
Every test and procedure we arrange.
Learn more