Our Summary

This research paper discusses a new method of performing hip arthroscopy, a type of minimally invasive surgery. This method is designed to repair the labrum, a ring of cartilage in the hip joint, in a way that better mimics its natural position.

Traditionally, during this type of surgery, the hip joint is pulled apart, or “distracted”, to allow the surgeon to perform repairs. However, this can make it difficult to accurately place the labrum and can also risk nerve damage due to the prolonged traction.

The new technique proposed in this paper involves only using traction when working on the central part of the joint, and then releasing it when repairing the labrum. This allows the hip joint to naturally bring the labrum into its correct position, which can help prevent the labrum from being incorrectly placed or flipped over.

By reducing the time the hip joint is under traction, this method could also reduce the risk of nerve injury. This new technique aims to recreate the natural structure and function of the hip joint more accurately after surgery.

FAQs

  1. What is the goal of arthroscopic labral repair?
  2. What are the risks associated with prolonged traction during hip arthroscopy?
  3. How does the presented technique prevent an “out-of-round” or everted repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair is to follow post-operative rehabilitation protocols closely to ensure proper healing and prevent re-injury. This may include physical therapy exercises to strengthen the hip muscles, as well as avoiding high-impact activities that could put strain on the repaired labrum. It is important to communicate with your doctor and physical therapist throughout the recovery process to ensure optimal outcomes.

Suitable For

Patients who are typically recommended for labral repair include those with femoroacetabular impingement (FAI), labral tears, hip dysplasia, and other hip conditions that result in pain, instability, and limited range of motion. These patients may have tried conservative treatments such as physical therapy, medications, and injections with little to no relief. Labral repair may be recommended for patients who have failed conservative treatments and are experiencing persistent hip pain and dysfunction. Additionally, patients who are younger and physically active may benefit from labral repair to restore function and prevent further damage to the hip joint.

Timeline

Before labral repair:

  1. Patient experiences hip pain, stiffness, and limited range of motion.
  2. Patient undergoes physical examination, imaging studies (such as MRI or X-ray), and possibly a trial of conservative treatments (such as physical therapy or medication).
  3. Diagnosis of femoroacetabular impingement (FAI) with labral tear is confirmed.
  4. Patient and surgeon discuss treatment options, including arthroscopic labral repair.

After labral repair:

  1. Patient undergoes hip arthroscopy with labral repair.
  2. Surgeon uses traction only for central compartment work, releasing traction to allow the femoral head to reduce the labrum to its anatomic position for acetabular recession, anchor placement, and suture fixation.
  3. Labrum is re-created in its anatomic position, restoring the suction seal against the femoral head.
  4. Patient undergoes post-operative rehabilitation and physical therapy to regain strength, range of motion, and function in the hip.
  5. Patient experiences improved hip symptoms, reduced pain, and increased mobility following successful labral repair.

What to Ask Your Doctor

  1. What is the success rate of labral repair surgery for femoroacetabular impingement?
  2. What are the potential risks and complications associated with labral repair surgery?
  3. How long is the recovery process after labral repair surgery?
  4. Will I need physical therapy after the surgery, and if so, for how long?
  5. What type of anesthesia will be used during the surgery?
  6. How long will I need to stay in the hospital after the surgery?
  7. What type of follow-up appointments will be necessary after the surgery?
  8. Will I need to make any lifestyle changes or modifications after the surgery to protect the repaired labrum?
  9. Are there any restrictions on physical activities or exercise after the surgery?
  10. What is the long-term prognosis for someone who undergoes labral repair surgery?

Reference

Authors: Skelley NW, Conaway WK, Martin SD. Journal: Arthrosc Tech. 2017 Oct 9;6(5):e1807-e1813. doi: 10.1016/j.eats.2017.06.061. eCollection 2017 Oct. PMID: 29416969