What Happens if Hip Arthroscopy Fails?
Hip arthroscopy is a minimally invasive procedure used to treat labral tears, femoroacetabular impingement (FAI), cartilage damage, and other joint problems. While success rates are high, not all patients experience the desired results.
When hip arthroscopy fails, patients may continue to suffer from pain, stiffness, or instability, sometimes requiring additional treatment or surgery. Understanding why this happens is the first step toward finding the right solution.
Signs That Hip Arthroscopy Has Failed
Common symptoms that may indicate a failed hip arthroscopy include:
- Persistent pain that does not improve after recovery
- Stiffness or reduced mobility in the hip joint
- Catching, clicking, or locking sensations during movement
- Instability or weakness, especially in athletes or active individuals
- Difficulty returning to normal activities or sport despite rehabilitation
Why Does Hip Arthroscopy Fail?
1. Residual Femoroacetabular Impingement (FAI)
The most common reason for failure is when bone overgrowth (cam or pincer lesions) is not fully removed, leading to continued impingement.
2. Progression of Arthritis
Hip arthroscopy is less effective in patients with advanced arthritis. If joint damage worsens, pain may persist despite surgery.
3. Labral Issues
- A labrum that re-tears after repair
- Incomplete repair or untreated tear at the time of surgery
4. Capsular Problems
If the hip capsule is left too loose, instability may occur. Conversely, if it is too tight, stiffness can result.
5. Scar Tissue or Adhesions
Excessive scar tissue inside the joint can restrict movement and cause ongoing pain.
6. Surgical or Technical Factors
Success depends on the surgeon’s experience and the complexity of the case. Incomplete correction of the underlying issue can lead to failure.
What Are the Next Steps if Hip Arthroscopy Fails?
1. Non-Surgical Management
- Physiotherapy to improve strength and mobility
- Injections (corticosteroids or PRP) to reduce inflammation and pain
- Lifestyle adjustments such as activity modification and weight management
2. Revision Hip Arthroscopy
If residual impingement, labral tears, or adhesions are identified, a second arthroscopy may be performed to correct the problem.
3. Hip Replacement Surgery
For patients with significant arthritis or severe joint damage, total hip replacement may be the best option for long-term relief.
How Common Is Failure?
Most patients experience positive outcomes, but studies suggest 5–10% of hip arthroscopies may fail or require revision surgery. The risk is higher in older patients and those with pre-existing arthritis.
Conclusion
If hip arthroscopy fails, patients may continue to experience pain, stiffness, and limited mobility. The most common causes are residual impingement, arthritis progression, labral re-tears, or scar tissue formation.
Next steps may involve physiotherapy, revision hip arthroscopy, or, in advanced cases, hip replacement. Consulting a specialist helps determine the best treatment path for lasting relief and improved function.