u/Breyber12

I see a fair amount of posts about labral tears/FAI impingement, surgery, and pregnancy. Being in my childbearing years myself, I decided to look into what I could find out there about this.

Notably, there does not appear to be a boatload of research nor any universal recommendations. 

Many people seem to struggle with timing surgery and pregnancy. Take care of it now so you’re (hopefully) more mobile and in less pain during pregnancy and while doing baby care? Or tough it out and wait cause there is a chance of tearing the labrum and worsening hip problems during pregnancy/childbirth? There isn’t a standard answer. 

I think it’s also really important to note that many healthy people have hip pain in pregnancy - at least a third, maybe more than half. So while us impinged people are probably guaranteed some hip pain in pregnancy whether repaired or not, it’s also super common in general. 

This is a pretty good general hip pain and pregnancy paper from 2025: https://pmc.ncbi.nlm.nih.gov/articles/PMC12446167/

Pregnancy-Related Hip and Pelvis Musculoskeletal Conditions, Risk Factors, and Prevention

It says “nearly all pregnant women endure some form of musculoskeletal disorder, with nearly 25% becoming temporarily disabled due to symptoms” and specific to FAI/labral tears “Literature is limited on the prognosis of acetabular labral tears specifically in the pregnant or postpartum patient. There are no established guidelines regarding when to undergo elective surgery for hip pain in the context of pregnancy, and little data exists on how previous hip arthroscopy may affect pregnancy outcomes.”

Regarding timing of surgery and pregnancy I was able to find this:

UR Medicine Orthopedics and Rehab recommends waiting 4-6 months after surgery before pregnancy. https://www.urmc.rochester.edu/getmedia/feb0f4b0-9a1f-4caf-a1e4-64e9560412b5/Hip-Arthroscopy-FAQ.pdf

My own surgeon's office said "whenever you are comfortable" when I asked about getting pregnant after surgery.

Pain and pregnancy complications data:

A single surgeon practice has been working on one of the more comprehensive studies I could find, and appears to have published their research in several places over 3 years, presumably as they continue to survey the practice's patients over time. The results concern 85 patients of childbearing age that had hip arthroscopy to treat impingement. 

Here’s the poster summary from 2023: https://pmc.ncbi.nlm.nih.gov/articles/PMC10392331/

Poster 227: The Impact of Hip Arthroscopy on Pregnancy-Related Decision-Making and Outcomes among Female Patients: A Single Surgeon’s Experience

Conclusions: “Within the hip arthroscopy population, although hip pain was exacerbated during pregnancy, most patients experienced a resolution of pain following delivery. Pregnancy-related complications did not occur more frequently in the hip arthroscopy cohort compared to the wider U.S. population.”

Here’s a full text published in 2024: https://www.mdpi.com/2673-4095/5/2/19

Pregnancy-Related Decision-Making and Perceptions of Risk among Reproductive-Age Females Undergoing Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Single-Surgeon Cross-Sectional Study

The full text does discuss a few reasons to time arthroscopy before pregnancy though there is no formal endorsed recommendation on timing - Improved ROM can make labor easier and reduce sexual dysfunction, and younger patients have better surgical outcomes. I find these arguments kind of weak personally - the birth position they mention is lithotomy, widely regarded as one of the worst! And as a female I do doubt that hip pain leading to sexual dysfunction would completely prevent someone from getting pregnant if they wanted to, though from experience I can say modifications might be needed. I also wish the authors would have mentioned the impact of BMI <24.5 being associated with better recovery and that people often have higher BMI after child birth, as well as the need to maintain strict at home PT regimen for a year + and how pregnancy could impact one’s ability to do that. Some studies also suggest having pain for more than 8 months pre op can lead to poorer surgical outcomes so that is worth a mention!

This study also notes that since there is little evidence on pregnancy and arthroscopy, and that using post arthroplasty outcomes is a reasonable comparison. In studies of women who got pregnant 3 years after THA there were no extra instances of pregnancy complications and 76% reported hip pain in 3rd trimester. 

Their final recommendations are “In lieu of more robust evidence, the authors propose the following conservative recommendations: (1) physical exam and imaging findings should be used to distinguish intra-articular versus extra-articular causes of hip pain in peripartum patients, (2) elective hip arthroscopy should not be performed during pregnancy as per ACOG guidelines, (3) reproductive-age females seeking arthroscopic treatment of FAIS should be made aware of the potential risk for rapidly progressive osteoarthritis during pregnancy, (4) surgeons should inquire about sexual dysfunction in female patients with FAIS and whether this is a barrier to attempts to become pregnant, and (5) reproductive-age female patients should be counseled about their expected outcomes following hip arthroscopy relative to their male and older counterparts.”

It is worth noting, the rapidly progressing osteoarthritis is related to a case report that describes 2 arthroscopy patients (treated for hip dysplasia) that developed aggressive osteoarthritis during pregnancy and required THRs. Notably, these patients were not treated for impingement but they did have arthroscopic hip surgery. I cannot find free access to the full text, but the abstract is available here: https://arthroscopyjournals.onlinelibrary.wiley.com/doi/10.1016/j.arthro.2012.07.004

Here’s another link to the abstract of the study findings published again in 2025:

https://www.sciencedirect.com/science/article/abs/pii/S0972978X2500073X?via%3Dihub

You can get full text access through patient request via Elsevier. They got back to me in 3 hours with a pdf. 

Pain worsens peripartum after hip arthroscopy for femoroacetabular impingement and may not return to pre-pregnancy improvement.

This write up seems to have a lot more data on patients that got pregnant after arthroscopy and I found it a very good read! Highly recommend getting full text if you are interested in this topic.

Highlights from the study include:

26 patients had a pregnancy after arthroscopy. 19 had never been pregnant. The timing of pregnancy ranged from 2-8 months post op. 19% experienced a miscarriage, 69% had hip pain during pregnancy. 

30% reported resolution of pregnancy hip pain when they did the survey. Of the people still in pain, 72% did say it was better than their pre op pain levels.

7 patients had been pregnant prior to surgery as well, 3 said the post op pregnancy pain was less severe than pre op pregnancy pain, 2 said it was worse, 1 said the same and the other didn’t respond. 

Bottom line: “patients who became pregnant postoperatively ultimately had good results as evidenced by their VAS and mHHS, a majority of them reported increased hip pain in the third trimester (69.2 %) and following delivery (73.1 %). Nearly half (47.4 %) specifically sought treatment for their hip pain. At final follow up, a majority (72.2 %) reported their symptom state had improved from the peripartum time period and was better than their initial preoperative state. However, a significant number (42.1 %) reported they still had not returned to their prior post- surgery, pre-pregnancy state of maximal improvement.”

The authors also had some insight in timing of pregnancy after surgery, “Of patients who experienced pregnancy postoperatively, patients became pregnant on average 6 months postoperatively. However, most subjects (76.9 %) stated that they would have preferred to wait at least 1 year after hip arthroscopy. Currently, there are no guidelines or literature regarding optimal pregnancy timing after hip arthroscopy.” 

My biggest takeaways are:

• A ton more research is needed! We need formal recommendations!
• There is no direct right or wrong answer to surgery or pregnancy first for people making that decision. There might be some evidence to support surgery first.
• Most people who got pregnant after surgery had hip pain and they stated they would have preferred to wait at least a year after surgery before getting pregnant. 
• People who were pregnant both before and after surgery said in a slight majority the post op pregnancy was less painful.