Our Summary

The acetabular labrum is a key part of the hip’s structure and function. Damage to it, or a “labral tear,” is a common issue often connected with a condition called femoroacetabular impingement (FAI) syndrome. For patients to recover well from this, it is crucial to restore the labrum’s shape and function.

The best surgical option to fix labral tears right now is labral repair or refixation, and there’s plenty of evidence suggesting that this method works well for a good amount of time. If the patient’s circumstances are right, another valid option is labral selective debridement, which is a bit like a clean up of the damaged area.

If the labrum can’t be repaired because there’s not enough healthy tissue, then doctors can turn to a method called acetabular labral reconstruction. This method is all about restoring the labrum’s sealing function, which is its ability to hold the hip joint together. Evidence suggests that this reconstruction leads to better patient recovery than removing the labrum.

This paper reviews when and why to use the reconstruction method, how it’s done, and what its outcomes are.

FAQs

  1. What is the importance of the acetabular labrum in hip biomechanics?
  2. What are the surgical options for labral tears?
  3. How does the outcome of labral reconstruction compare to resection?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair is to follow a comprehensive rehabilitation program after surgery to optimize outcomes and ensure proper healing. This may include physical therapy exercises, activity modification, and gradual return to normal activities. It is important to follow the guidance of healthcare professionals and adhere to the prescribed rehabilitation plan to achieve the best results.

Suitable For

Patients who are typically recommended labral repair include those with symptomatic labral tears, especially those associated with FAI syndrome. Patients who have failed conservative treatment and continue to experience hip pain, clicking, locking, or catching may benefit from labral repair to improve their symptoms and function. Additionally, patients with hip instability, dysplasia, or other hip abnormalities may also be candidates for labral repair to address their underlying hip pathology. It is important for patients to undergo a thorough evaluation by a hip preservation specialist to determine if labral repair is the appropriate treatment option for their specific condition.

Timeline

Before Labral Repair:

  1. Patient experiences hip pain or discomfort, often exacerbated by physical activity.
  2. Patient may undergo imaging studies such as MRI to diagnose a labral tear.
  3. Conservative treatment options such as physical therapy or anti-inflammatory medication may be attempted.
  4. If symptoms persist, patient may be recommended for arthroscopic labral repair surgery.

After Labral Repair:

  1. Patient undergoes arthroscopic labral repair surgery to repair the torn labrum.
  2. Post-operative rehabilitation program is initiated to help patient regain strength and mobility in the hip.
  3. Patient gradually resumes physical activities and sports under the guidance of a physical therapist.
  4. Follow-up appointments with the surgeon are scheduled to monitor the progress of the hip and evaluate the success of the surgery.
  5. Patient may experience improved hip function, reduced pain, and enhanced quality of life following successful labral repair surgery.

What to Ask Your Doctor

  1. Can you explain the specific type of labral tear I have and how it is affecting my hip biomechanics?
  2. What are the potential risks and benefits of undergoing labral repair surgery?
  3. How long is the recovery process after labral repair surgery, and what can I expect in terms of pain and mobility?
  4. Are there any alternative treatment options to consider before moving forward with labral repair surgery?
  5. What is the success rate of labral repair surgery in terms of improving patient-reported outcome measurements and overall hip function?
  6. Will I need physical therapy after the surgery, and if so, for how long?
  7. How often should I follow up with you after the surgery to monitor my progress and address any concerns?
  8. Are there any specific restrictions or precautions I should follow after the surgery to ensure optimal healing and recovery?
  9. What can I do to prevent future labral tears or hip issues after undergoing labral repair surgery?
  10. Are there any additional resources or information I should be aware of regarding labral repair surgery and hip preservation?

Reference

Authors: Maldonado DR, Glein RM, Domb BG. Journal: J Hip Preserv Surg. 2021 Apr 21;7(4):611-620. doi: 10.1093/jhps/hnab003. eCollection 2020 Dec. PMID: 34377505