Hip Specialist NYC — Joint Preservation & Orthopedic Hip Surgery at NY Bone & Joint

A Cam impingement occurs when the head of the femur (thighbone) is not perfectly round, creating a prominent bony bump that grinds against the socket rim during flexion. A Pincer impingement occurs when the acetabulum (hip socket) projects too far outward, over-covering the femoral head and pinching the protective labrum during movement. Most active individuals suffer from a mixed impingement — a combination of both structural bone abnormalities. [1] Clinical diagnosis uses the FADIR test (Flexion, Adduction, Internal Rotation), which reproduces the characteristic groin pain when the impinging surfaces are compressed.

Not always. Hip labral tears without significant mechanical symptoms — and without the FAI bony abnormality that caused the tear — can often be managed non-surgically with physical therapy and activity modification. [1] Surgery is appropriate when: the labral tear is causing significant symptoms that have not responded to conservative management, the FAI anatomy is present and is expected to cause ongoing damage to the labrum and cartilage, or the labrum has a structural tear that is mechanically symptomatic.

Hip arthroscopy is a minimally invasive surgical procedure performed through small portals around the hip joint. The surgeon uses a camera to visualize the joint directly and instruments to correct the FAI bony abnormality, repair the labrum, address cartilage lesions, and treat other intra-articular pathology. [2] It is performed as an outpatient procedure at Lenox Hill Hospital. Most patients bear weight the same day.

Return to sport after hip arthroscopy for FAI and labral repair is typically 5–6 months with criteria-based clearance. [3] The first four to six weeks involve protected weight-bearing and passive range of motion. Progressive strengthening begins at 12–16 weeks. Sport-specific activity begins at 4–6 months. Full return to competitive sport is based on strength symmetry testing and functional assessment, not the calendar.

Yes — both are available at NYBJ. Hip arthroscopy preserves the native joint through small portals for structural problems — FAI, labral tears, cartilage lesions. Total hip replacement removes worn joint surfaces and replaces them with prosthetic components for advanced bone-on-bone arthritis. Dr. Tarwala holds fellowship training in both hip preservation (Ohio State) and total joint replacement (Lenox Hill Hospital), meaning patients at any stage of hip disease are treated within the same practice without external referral.

No — hip pain can originate from the hip joint itself (FAI, labral tear, arthritis), from the surrounding soft tissues (greater trochanteric bursitis, gluteal tendinopathy, iliopsoas tendinopathy), from the lumbar spine (referred pain from disc herniation or radiculopathy), or from the sacroiliac joint. [1] At NYBJ, Dr. Tarwala’s evaluation is designed to identify the true source of pain before any treatment is recommended. A cortisone injection into the wrong structure will not help — and can delay the correct diagnosis.

Mild hip dysplasia with an intact labrum can sometimes be managed with physical therapy and activity modification. When the labrum is torn secondary to dysplastic instability, careful arthroscopic labral repair may be appropriate in mild cases, but the labrum must not be over-tensioned in a dysplastic hip. [6] Moderate-to-severe dysplasia causing significant instability and progressive labral overload is best addressed with a periacetabular osteotomy (PAO) — a procedure that reorients the acetabulum to restore coverage. Dr. Tarwala evaluates each dysplastic hip individually and discusses referral to a PAO specialist when indicated.

Most major insurance plans are accepted at NYBJ for hip consultations, diagnostic imaging, physical therapy, and surgical procedures including hip arthroscopy and total hip replacement. Our team verifies coverage before scheduling procedures. Call 212-759-4553 to confirm your specific plan.