Labral tears in the hip might cause painful locking or clicking of the hip, reduced range of motion, and disruption to daily activities and sports. The acetabular labrum aids in the stabilization of the hip joint, especially during hip motion. The fibrocartilaginous structure extends the acetabular rim and offers a suction seal around the femoroacetabular interface.
Hip labral tears do not heal easily so that surgery may be necessary in many cases. Surgery aims to improve hip stability, function, and range of motion, decrease hip pain, and prevent additional damage to the hip joint. But is labrum repair a major surgery?
A hip labral tear is a type of injury that impacts the hip's labrum. This tough, crescent-shaped cartilage structures the rim and lines of the hip socket (called the acetabulum), which is found in the pelvic bone. Also called the acetabular labrum, it shouldn't be confused with the shoulder labrum, which is a similar structure known as the glenoid labrum.
The hip functions like a ball-and-socket joint, with the head of the femur (the thighbone) forming a "ball" that fits into a "socket" known as the acetabulum found in the pelvis. Both the ball and socket have smooth articular cartilage covering them. The labrum is an extra, specialized piece of cartilage that runs along the socket's rim to provide a suction seal and stability to your hip joint. It helps absorb shock and spread pressure during hip movement, ensuring smooth motion. The hip labrum may become torn or detached from the acetabular socket for various reasons.
A torn labrum can be caused by:
·Repetitive motions over time lead to "wear and tear."
·A traumatic injury is very common in athletes who carry out repeated hip flexions and sudden impact on their hips, such as hockey players, runners, soccer players, and football players.
·Individuals with other conditions of the hip can be especially susceptible to labral tears. These include:
·Hip impingement (also called femoroacetabular impingement) is a condition in which abnormal contact between the hip's ball and socket is due to a deformity of the acetabulum or the femoral head.
·Osteoarthritis of the hip, a cartilage degeneration, can lead to rough, bone-on-bone contact in the hip.
Hip labral tear symptoms can include:
·Deep pain in the groin or the buttocks on the side of the injured hip's side.
·A sound or feeling of locking or clicking when your hip is in motion.
·Hip pain, particularly while it rotates in specific directions.
·Stiffness while moving your hip.
Labral tears are hard to diagnose, partially due to the many muscles and other structures near the hip joint. They are usually misdiagnosed as common groin strains, and it isn't uncommon for the diagnosis to be missed for several months after your labrum is torn.
A sports medicine physician or orthopedist will perform a physical exam and consider your symptoms. If your doctor thinks you might have a torn labrum, they will order hip imaging. This may include X-rays, but a hip MRI is the best way to confirm the diagnosis.
Your doctor might advise hip arthroscopy if you have a severe tear or if a nonsurgical procedure won't provide adequate relief. This type of arthroscopic procedure is usually done on an outpatient basis. The procedure is small incisions about half a centimeter around the hip using specialized instruments to either debride (clean) remove the injured labrum or reattach it to the socket. Following the surgery, you'll be discharged on crutches and use them for 2-6 weeks. This length of time is identified on a case-by-case basis. Post-surgical physical therapy will improve your muscle strength around the hip and range of motion.
Whether treated nonsurgically or surgically, recovery from a torn hip labrum can last up to six weeks. Based on the extent of the injury, competitive athletes may return to their sport between two and six months after the injury.
During surgery, a doctor might perform:
Labral tear repair. Your doctor will reattach the torn labrum to the socket (acetabulum) with small plastic "anchors" and sterile thread.
Debridement. This technique involves trimming or smoothing the frayed area of the labrum. The goal is to remove damaged, loose, and pain-generating tissue.
Other repairs. Hip problems are usually intertwined, so it's typical for a surgeon to repair your hip labrum and deal with other problems during the same surgery. For instance, the surgeon might repair the labrum and shave down bony abnormalities that lead to hip impingement.
Other repairs may be made during surgery. Pre-operative medical imaging cannot always reveal everything wrong in a joint. A surgeon might confirm or discover other hip issues for the first time during surgery.
Labral reconstruction utilizes a graft—tissue from another part of the body or a donor—to completely replace the torn labrum. This procedure occurs when the labrum is so damaged that it can't repaired, but the hip joint is otherwise healthy.
The type of surgery advised will be based on the severity of your injury or condition and other underlying conditions that must be addressed.
People considering hip labrum repair should consider how they cope with post-surgical recovery.
Recovery often requires:
·Taking pain medication for 1-3 days
·Using crutches (in some instances, a walker might be needed initially)
·Dedicating time to physical therapy
Many patients are eager to learn about their anticipated recovery from labral tear hip surgery. That said, it's crucial to remember that each treatment and recovery will differ for everyone. Postoperative recovery times differ depending on the severity of your hip labrum tear, related chronic conditions, and other factors. Nevertheless, most patients should expect to utilize crutches for the first two weeks after their hip labrum surgery. Some patients may need six months to recover from hip labrum surgery fully. No matter how long it takes, your doctor will track your progress during hip labral tear surgery recovery and suggest a rehab strategy, including torn labrum hip exercises when appropriate.
People with sedentary jobs often return to work 1-2 weeks after arthroscopic hip labrum surgery. Prolonged sitting isn't recommended, so these individuals will be encouraged to stretch and move intermittently across the day.
People with labor-intensive jobs, like those requiring heavy lifting or standing for long periods, may need to wait up to 6 months following arthroscopic hip surgery before returning to work.
Generally, an individual who has undergone arthroscopic hip surgery can return to moderate activity, like jogging, after three months, although some people may be required to wait longer. For high-hip-intensity sports, such as ballet, football, rowing, and lacrosse, a 5—to 6-month timeframe for recovery is typical following hip arthroscopy. This time frame depends on many factors, such as the type of surgery performed, the person's fitness level, and the sport itself.
Arthroscopic surgery is virtually always an outpatient procedure, and you might expect to go home within hours of surgery. Most people can walk with crutches almost immediately after the procedure. Our pain management experts ensure you have the medication to stay comfortable during recovery.
Doctors suggest using crutches for 2-3 weeks, and your surgeon books a follow-up appointment for two weeks after surgery to take off the stitches and confirm that your incision wounds are healing normally. Your surgeon also checks your hip and asks you to rotate your leg gently in various directions to assess its range of motion following surgery.
Our doctors suggest starting physical therapy in the days following surgery. Physical therapy helps rebuild hip muscle flexibility, range of motion, and strength.
At Sunnyvale Sports Medicine, we specialize in the latest conservative care treatment options and arthroscopic surgical techniques to treat hip labral tears. If you or a loved one are being held back by the pain and discomfort of a hip labral tear, come for a consultation to learn more about the latest treatment alternatives. Our team is committed to allowing patients to achieve their active lifestyle goals without limitations.