I’m almost three months out from a right hip arthroscopy that involved a substantial bone reduction (both the femur and the socket) and the repair of a torn labrum. It’s too soon to say whether this surgery achieved all the goals I’d like it to achieve, but I’m writing this post to summarize my recovery, since maybe 80% of online discussions of this issue say a lot of scary things about recovery, and I’m trying to compensate for a bias where mostly only people with scary things to say post anything about their recovery. tl;dr: recovery was much easier than expected, and at three months out I can do all my normal activities – including running moderate distances – except that I can tell I’m not quite ready for sports that involve lateral movement. I didn’t have to take any time off from work.
The long version…
I’m a 46-year-old male, and although I’ve never been a serious athlete, I enjoy amateur sports: prior to this issue, I ran maybe 25 miles a week, played frisbee or soccer a handful of times a year, went skiing maybe twice a year, etc. Basically a typical weekend warrior type, other than daily short runs. Obviously everyone took some time off from group sports during COVID, and when I started up with sports again in ~2022, I noticed that after long runs or any sports with side-to-side cutting (frisbee, basketball, pickleball, etc.), I was unreasonably stiff starting a couple hours afterwards, particularly in my right leg. Not exactly sore, just stiff. I wrote it off as age and some lost fitness, but by late 2023, if I so much as played ping-pong (yes, really, ping-pong!), I was so stiff I could barely walk and had to crawl up stairs. It typically resolved after ~24 hours. Running was mostly OK, but around late 2023, running started to add up as well, where instead of getting that debilitating stiffness after 10-mile runs, I was getting those symptoms after a couple days of 4-mile runs. Basically everything was heading in the wrong direction, so I went to an orthopedist to get a better sense of what was going on.
X-rays showed pretty severe malformation of the femoral head on both sides, which I’ve probably had my whole life, and it likely caused gradual wear on the soft tissue that eventually added up to a diagnosis of FAI (if you’re still reading, you know what that is). The first doctor I talked to basically said the soft tissue was probably too damaged to bother with surgery other than hip replacement, but that my symptoms weren’t as severe as a typical hip replacement patient, so he basically left it up to me whether to (a) back off and avoid sports forever, or (b) run it into the ground until the only option was replacement, which he thought would go well, but would probably be the end of most of the sports I enjoy. I was leaning toward option (b), but I took some time off of sports other than running and started self-guided PT at home (I discuss the program I tried here). Maybe rest and PT slowed the damage down, but things definitely didn’t turn around: after a few months off, I tried some easy sports (e.g. pickleball), and it was a total disaster every time.
So in the middle of 2024, I saw a surgeon in the Seattle area… spoiler alert: I really liked this surgeon, and while I feel odd posting his name for some reason, I’ll share his name if you email me. I chose this surgeon based on self-reported specialization in hip preservation surgery, i.e. arthroscopy, and a significant number of patient reviews that discussed arthroscopy. After ordering an MRI, he was more optimistic than the previous doctor about the degree to which there was soft tissue left to save, but agreed that it wasn’t an obvious call: arthritis has started, and some tissue has worn away. FWIW, leaving it up to me and not insisting hard in either direction is basically exactly what I want from a surgeon. I proceeded with RH arthroscopy in early October 2024.
My surgery was scheduled for 8:30am… I mention that because the course of the day set the tone for my recovery. Surgery started on time, took maybe an hour, and at 9:30am I was alert enough to discuss the procedure with my surgeon. He found more soft tissue damage than he expected, including a torn labrum that was not obvious on MRI, but he repaired the tear, removed loose tissue that couldn’t be re-attached, and removed a significant amount of bone from both the femoral head and the socket. By 10am I walked out with crutches, and by noon I was standing at my desk at home and working at a perfectly productive level. That’s a good start to recovery!
Everything was great until the swelling kicked in at around 9pm, and the first night of recovery was the only part of the whole experience that was a little brutal; I spent pretty much the whole night groaning and rolling around in pain. But starting the next day, things got a lot better, and the pain responded well to a moderate dose of painkillers. I have a desk job and I work from home, and I felt well enough after the first night that I didn’t need to take any time off. The crutches were impractical for the layout of my house, so I switched to a cane the day after surgery, and I was able to get around the house fine; the cane was really just there to keep me from doing silly things like running up the stairs. I took a pretty low dose of painkillers for maybe a week, and by ~1 week post-op I felt pretty much normal. Not like “go play basketball” normal, but I could do normal stuff, and I was off of painkillers. I was driving after a little less than two weeks, and could walk my big dog (still with the cane) at around the same time (~2 weeks post-op). I obviously wasn’t doing any sports, but I went for long walks around the neighborhood with my cane and my iPod, and I watched a ton of football.
At two weeks I had a follow-up x-ray that showed nothing out of the ordinary, and that was also my last day with the cane. My surgeon cleared me for light lifting and the elliptical machine at that point, and I spent the next couple weeks playing the new Call of Duty on the elliptical for maybe 30 minutes a day. At around four weeks, I started taking a few jogging steps during my walks every day to make sure nothing bananas happened, and at around six weeks, I jogged a mile, then took a day off, then jogged a mile, etc. I gradually ramped that jogging up to around three slow miles, never two days in a row. I had a bit of a regression when I added back some self-guided PT again, which felt great while I was doing it, but triggered symptoms the next day, so I dropped the PT and just alternated lifting/jogging/rest.
Now I’m at ~three months post-op, and I’m running three or four miles at a not-entirely-unreasonable pace, never more than two days in a row. I no longer have random steps where I feel pain (that happened occasionally until maybe two weeks ago), and my range of motion is almost normal… or, I guess, normal for me, which is well below average even for an injury-prone middle-aged man, but… normal for me. I played ping-pong this week with no symptoms, which sounds like damning my recovery with faint praise, but it was a big step for me. My goal now is to ramp up to actual sports over the next ~two months (i.e., trying some actual sports at ~five months post-op), not so much because I’m burning to get back to sports, but because I have the same anatomical issues on the left side and some of the same symptoms, and I want to test everything to assess whether I want to do this on the left side as well.
Hopefully this is helpful to folks considering arthroscopy for FAI… definitely a process, and it’s too soon to say whether the surgery will ever get me back to sports (though I’m optimistic!), but overall, coming from someone who has had a weird number of surgeries for a generally healthy person, this was the easiest surgical recovery I’ve ever had. So I don’t have any data that would necessarily encourage anyone to have hip arthroscopy, but I have a data point that would cause someone to be less scared of the procedure than other online discussions might imply.
