Surgery for Repairing a Torn Hip Labrum
When the labrum of the hip is torn and is causing significant symptoms, including pain or range of motion issues, the typical, first course of action is conservative treatment including rest and anti-inflammatory medication. However, this does not always lead to sufficient relief. At that point, we may use corticosteroid injections to try to control the inflammation and return the hip to its normal function. When all of these options fail, surgery to repair a torn labrum is considered.
There are several surgical procedures that may be employed to repair the labrum, reshape the hip joint or reconstruct the labrum. These include hip arthroscopy, hip dislocation, labral reconstruction and periacetabular osteotomy.
Hip arthroscopy is a minimally invasive procedure, performed using tiny incisions just above the hip, using a miniature fiber-optic camera to visualize the hip joint and surgical field. For surgical candidates in relatively good health, hip arthroscopy is usually the best option. For most, the procedure is performed as outpatient surgery, meaning patients can return home on the same day of surgery. After a relatively short period of rest, patients will be back to day-to-day activities, and when cleared by Dr. Manning, can return to normal, more strenuous activity.
Hip arthroscopy is used to repair the torn labrum. This is done through the use of anchors and sutures that reattach the torn cartilage mechanically. Once the procedure is complete, the labrum should function as normal, re-creating the formerly snug fit in the joint and improving the function of the hip. During arthroscopy, Dr. Manning may find other irregularities that can possibly be corrected at the same time.
After surgery, crutches will be necessary for approximately three weeks. A follow-up appointment will be scheduled two weeks after surgery to ensure recovery is progressing nicely. During this time, physical therapy will also be necessary to improve movement within the joint, speed up recovery, and enhance muscle strength in the area. Patients can typically return to normal activity within a few months.
Labral reconstruction may be necessary if a repair is impossible due to significant degeneration of the cartilage making up the labrum. Essentially, Dr. Manning cuts away the diseased labral cartilage and grafts healthy cartilage from another part of the body or from donor tissue. Other than using grafted tissue, the procedure is very similar to a labral repair and is typically performed arthroscopically.
Recovery from labral reconstruction is similar to that of a repair, however there are more variables depending on the degree of damage to the labrum and how extensive the reconstruction was. Once again, a few weeks on crutches along with physical therapy lends itself to the best outcomes and ultimately return to normal function.
If there are structural problems in the hip joint, a surgical hip dislocation, where the hip joint is exposed and ultimately dislocated to perform the procedure, may be necessary. Some patients, especially those with hip dysplasia, may also require a periacetabular osteotomy where the acetabulum is realigned to fit more snuggly on the head of the femur. Both of these procedures are more involved and are typically reserved for those patients who have injuries above and beyond a simple labrum tear.
If you are experiencing pain or dysfunction of the hip, it is important that you speak to Dr. Manning as soon as possible to understand the nature of the problem and the best treatment options.