Our Summary

This research paper focuses on hip arthroscopy, a surgical procedure used to diagnose and treat problems in the hip joint. The paper states that this procedure is effective and that the methods and tools used in this procedure are rapidly improving. It’s generally agreed upon that the usual process of repairing the labrum and capsule (parts of the hip joint) is the best approach, and this is backed up by long-term studies.

A key part of a patient’s recovery after this surgery is physical therapy. While it’s tempting to speed up this process, studies have shown that the hip joint is less stable immediately after surgery, especially after labrum repairs. So, even though doctors want to help their patients recover quickly, they also need to make sure the hip joint is protected in the early stages after surgery.

If lab tests show that we cannot fully restore the stability of the hip joint, we must assume that the healing process of the labrum and capsule after surgery will improve the stability. This means that the strength of the repair alone is not enough and there’s a period after surgery where the hip joint is especially vulnerable. Therefore, most treatment plans for hip arthroscopy include a ‘protection period’ that lasts between 4 to 8 weeks. During this time, patients are encouraged to only perform movements within a comfortable range, and they are strongly advised against pushing themselves to the point of pain.

FAQs

  1. What is the standard of care post hip arthroscopy, specifically for labral repairs?
  2. How crucial is physical therapy in the success of postoperative recovery after labral repair?
  3. How long is the protective period typically recommended after hip arthroscopy, and what does it involve?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair is to follow their postoperative physical therapy program diligently. This is crucial for optimal healing and to prevent complications. It is important to listen to your body and not push yourself beyond what is comfortable during the initial healing period. Be patient and allow your hip to heal properly before gradually increasing activity levels. It is also important to communicate any concerns or difficulties with your healthcare provider to ensure the best possible outcome.

Suitable For

Patients who are typically recommended labral repair include those with symptomatic labral tears, often due to femoroacetabular impingement (FAI) or hip dysplasia. These patients may present with hip pain, clicking, catching, or locking, as well as limited range of motion and decreased hip function. Labral repair is also recommended for patients with recurrent hip instability or dislocations, as well as those with traumatic labral tears.

It is important for patients to undergo a thorough evaluation by a hip specialist to determine if they are good candidates for labral repair. Factors such as age, activity level, severity of symptoms, and underlying hip anatomy will all play a role in the decision-making process. Additionally, patients should have realistic expectations about the outcomes of surgery and be willing to commit to a comprehensive rehabilitation program postoperatively.

Overall, patients who are motivated to improve their hip function and willing to participate in physical therapy are typically good candidates for labral repair. It is important for patients to work closely with their healthcare team to ensure a successful outcome and minimize the risk of complications.

Timeline

Before labral repair:

  1. Patient experiences hip pain, clicking, or locking, often during physical activity.
  2. Patient undergoes physical examination and imaging studies to diagnose labral tear.
  3. Patient discusses treatment options with orthopedic surgeon, including hip arthroscopy.
  4. Patient undergoes preoperative evaluation and preparation for surgery.

After labral repair:

  1. Patient undergoes hip arthroscopy procedure to repair labral tear.
  2. Patient wakes up in recovery room and begins postoperative pain management.
  3. Patient is instructed on postoperative restrictions and weight-bearing status.
  4. Patient begins physical therapy to improve hip range of motion and strength.
  5. Patient follows a protective period of 4 to 8 weeks, focusing on passive range of motion and avoiding pushing beyond pain.
  6. Patient gradually increases activity level under guidance of physical therapist and surgeon.
  7. Patient progresses to more advanced strengthening exercises and functional activities.
  8. Patient continues to follow up with surgeon for monitoring of hip healing and progress.

What to Ask Your Doctor

  1. What is the success rate of labral repair surgery in terms of pain relief and improved function?
  2. What are the potential risks and complications associated with labral repair surgery?
  3. How long is the recovery period after labral repair surgery and what can I expect in terms of physical therapy and rehabilitation?
  4. Will I need to modify my daily activities or exercise routine after surgery?
  5. What are the chances of re-injury to the labrum after surgery and what steps can I take to prevent it?
  6. How often will follow-up appointments be needed after surgery to monitor my progress?
  7. Are there any specific restrictions or precautions I should be aware of during the early postoperative period to protect my hip?
  8. What is the expected timeline for returning to full activity or sports after labral repair surgery?
  9. Are there any alternative treatment options to consider before deciding on labral repair surgery?
  10. What is the experience and success rate of the surgeon in performing labral repair surgeries?

Reference

Authors: Kaplan DJ. Journal: Arthroscopy. 2025 Mar;41(3):685-687. doi: 10.1016/j.arthro.2024.06.006. Epub 2024 Jun 11. PMID: 38866375