Hip Arthroscopy & Surgery in Atlanta.
What hip arthroscopy is, and where the portals go
This is a surgery performed inside the joint by way of a few small holes instead of one large one. The holes are the portals. A camera passes through one portal; instruments go through the others; and the surgeon operates while looking at the image displayed on a monitor.
The portals are positioned on the outside of the hip over the joint, in such a way that instruments can reach the ball and socket of the hip without cutting through any more tissue than necessary. Because the hip joint is deep and encased, the patient's leg is suspended in a traction device that pulls the leg away from the body, opening up the joint space. Fluoroscopic (live X-ray) images help the surgeon see where the portals should be. Each portal passes through the capsule, which surrounds the hip joint.
Is it a major surgery? Yes, it is actual surgery, requiring anesthesia, working inside the joint on bone and cartilage, and a rehabilitation process that requires patience. However, it is not an open procedure with a single long incision as it once was. If a hip condition requires surgery, whether it is a hip labral tear or a worn patch of cartilage, arthroscopy is usually the way in, and most people get there only after every other option has been exhausted. That path almost always starts back at hip pain itself.
Who hip preservation surgery is for
Hip preservation surgery is for a hip whose issue is mechanical and whose cartilage is still worth preserving. It is a group of operations with a single goal: keeping your natural joint in a form that can function. Trimming back the bone that causes impingement and fixing a torn labrum are the most typical, along with treatment of damaged cartilage and procedures to salvage the ball of the femur when the bone inside it has lost its blood supply, a condition doctors call avascular necrosis.
The signs it fits are fairly plain: damage in one spot rather than everywhere, pain that has not yielded to everything short of surgery, swelling that keeps coming back, a loose fragment, or a hip that clicks and locks. Each of those points at a mechanical problem arthroscopy can actually reach.
The conditions where it does not fit are just as plain: cartilage loss across the whole joint, inflammatory arthritis, or anything else that prevents cartilage from healing. One structural problem sits outside its reach: hip dysplasia, a malformation where the socket does not cover the ball adequately, needs open surgery. It is still joint preservation, because the goal is still the same. Whether it is worth it is a decision we make together, and the demands are real: time without full weight on the leg, months of rehab, and the possibility of further work down the road.
A deformed hip does not fix itself, and no amount of reading fixes it either. An exam and imaging show what is happening inside, so if yours has bothered you long enough to bring you this far, request an appointment.
What gets tried before an operation
Doc did my FAI surgery on both hips. One year later I am back to running, swimming, and CrossFit pain-free. I feel fantastic. THANK YOU DR. LANGER!
Virtually everything short of a replacement begins with changing how the joint is used: trading running for swimming or cycling, using a cane for a long day, and dropping the positions that reliably set it off, like sleeping on the painful side or crossing your legs.
Physical therapy covers the structural part: stretching keeps the joint from tightening, and strengthening the muscles surrounding the hip and pelvis provides stability so that the joint isn't responsible for supporting itself.
Anti-inflammatory medication can help while inflammation settles, and an ultrasound-guided injection is another option, though the relief is temporary and its length unpredictable. The approach here is to begin with interventions that don't involve steroids, and regenerative medicine sets out what it reaches for instead. Older patients ask about alternatives more than anyone, and age by itself is not what decides. The state of the joint decides, along with what you need it to do.
Where cartilage is worn across the whole hip rather than in one patch, an arthroscopic operation has little to offer, which puts more weight on this program, not less.
Plenty of hip trouble never involves the inside of the joint. Bursitis at the side of the hip and irritation of the piriformis, a muscle deep in the buttock, both usually settle without surgery.
All of it is worth doing, and none of it repairs damage: it manages symptoms without restoring worn cartilage or changing the bone shape underneath.
How long hip arthroscopy recovery takes
Every version of the recovery question wants a number, and the honest answer is phases, not weeks. What was done inside determines the timeline, and each phase begins when the hip is ready.
The first days.
The work is calming the incisions and the inflammation: rest, ice, the leg propped up, the pain managed. This phase is not about progress; it is about protection.
The brace and the crutches.
A brace restricts extreme hip motion to protect the labral repair and any reshaped bone as the capsule heals.
Crutches relieve weight from the leg until it's ready to bear your weight, protecting the joint as much as your balance allows.
Therapy, and walking without help.
Physical therapy begins early, and its first job is moving you without stressing the healing tissues. It brings back movement before it brings back strength. The goal in this phase is to help you walk normally without crutches.
Building the hip back.
Once the hip can stand it, the work gets harder: strength through the hip and pelvis, followed by load and range combined. This is the longest phase, but also the least exciting.
Back to your sport.
The last phase, and the most demanding. Its timing is dictated by hip capacity at full demand, not by any predetermined date.
No one can hand you a finish date up front without guessing. One hip with reshaped bone and a repaired labrum protects more tissue than another with a little patch removed, and two hips with the same procedure will progress in different ways. Whenever the procedure was arthroscopic (which is most often), recovery from hip preservation surgery and recovery from a hip arthroscopy are the same discussion. Your surgeon's protocol governs, and it is written for the hip that was actually operated on.
How well hip arthroscopy works
Was referred to Dr. Langer for a complex hip issue. Have been nothing but impressed by him, his staff and his capabilities.
No single figure describes how well hip arthroscopy works; any page quoting one is talking about someone else's patients. Studies tally different procedures in different hips, by different outcomes. They all point the same way, but they don't all agree on the number.
There are three outcomes that matter most to most people:
- Does the pain that caused you to get the procedure go away?
- Does the hip do what you want it to?
- Do you have to have another operation down the road?
The published comparisons favor the arthroscopic approach on the second two, with patients reporting better comfort and fewer returns for further surgery.
The biggest factor in your outcome is not a general success rate but the condition of the joint at the time of surgery: a hip that has already turned arthritic rarely benefits from impingement surgery. The other big factors are what the surgeon finds once inside and how the rehabilitation goes, because the operation and the recovery are really one process.
The best discussion will be focused on your hip: what your imaging shows, what your exam findings reproduce, and what you want your hip to be able to do. It should include an honest assessment of whether surgery would help or hurt your situation, and that is something worth knowing up front.
Where Dr. Langer trained in hip arthroscopy
Hip arthroscopy is a technical procedure, and where a surgeon was trained matters much more in this case than it does for most surgeries. Completed advanced fellowship training in Hip Arthroscopy with Marc Philippon, MD.
That is training in this specific operation, over and above an orthopedic residency and beyond standard sports medicine training.
The society membership continues the same thread. Active member of the Arthroscopy Association of North America (AANA). Dr. Langer's training is laid out in full on the about page.
In the exam room it means answers first, instruments second: a history, a reproduction of the pain, an imaging study aimed at something specific. Inside the joint, the logic is joint preservation: keep as much of the labrum as can be kept, fix the shape causing the trouble, and end with a hip that can take care of itself.
Atlanta patients come to this page from both directions: some wondering whether surgery is even on the table, some with a date already set and wanting to know what happens next. Either way the next step is the same. Request an appointment and start with what the joint looks like.
Start with clarity about your hip.
If pain is limiting the way you train, work, sleep, or move, an evaluation can turn uncertainty into a practical next-step plan.
Book an appointment →-
A focused conversation
Explain what you want to return to, not only what hurts.
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A whole-hip assessment
Look for the combination of findings that best explains the symptoms.
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A clear next-step plan
Understand the likely cause, whether imaging helps, and what comes next.
Care built around diagnosis, clarity, and durable function.
Atlanta Sports Medicine Institute helps active patients understand what may be driving their symptoms and compare appropriate treatment paths. The experience should be precise, understandable, and tied to the activities each patient wants to return to.
Can you walk after a hip arthroscopy?
Yes, with crutches at first. You take them home and use them until the hip can support your weight; they keep load off the healing joint and keep you stable while it does. Walking on your own is a goal that physical therapy works towards, rather than something you just wake up and do. Your leg needs to learn how to control your hip again before you start walking on it, and you need to re-learn how to walk normally instead of limping around.
How painful is hip arthroscopy surgery?
You're out during the surgery, so you don't feel anything. It's the post-op period that hurts. The first days are rest, ice, the leg elevated, and the medication your team prescribes. How much pain you experience depends on the procedure. A hip that had the bone reshaped and the labrum repaired has more to heal from than one that had a small area cleaned out.
How painful is recovery from hip surgery?
It is different at different times. At first it is post-operative soreness that responds to rest, ice, elevation, medication, and not overdoing it. Later it comes more from rehab than from the surgery, and that kind tends to be easier to manage. What you don't want is increasing pain after pain was decreasing. That's when you contact the surgeon.
Ready to be seen? Book an appointment.
Tell us what is bothering you and we will get you in front of the right person.