Labral Tears of the Hip
This condition is a tearing of the labrum - a thick cuff of fibrous tissue that lines the hip socket. The labrum cushions the joint and provides a smooth surface for the head of the femur to glide within the socket. A torn labrum can interfere with the normal motion of the hip joint.
The labrum is a protective layer of cartilage found in the ball and socket joint of the hip. It provides the relatively shallow hip joint with more stability, cushioning and a full range of motion. A tear in this cartilage, known as a labral tear, is often caused by either trauma to the hip or chronic overuse. These injuries are more common in individuals who play certain sports, such as golf or hockey, which require repetitive twisting or pivoting motions. In other cases, a tear may be the result of excessive wear on the labrum due to anatomical abnormalities in the structures of the hip joint. A labral tear can lead to pain, stiffness and a feeling of catching or clicking within the joint while moving.
To diagnose a labral tear, the physician will perform a physical examination and take a thorough medical history. It is frequently initially misdiagnosed since a labral tear has similar symptoms to a number of other physical problems. To confirm a suspected diagnosis, an injection of anesthesia may be administered to determine that the source of the pain is within the joint. Testing may include X-rays or an MRI scan to provide a precise view of the structures of the hip joint.
The Labral Repair Procedure
While some labral tears can be treated by managing pain symptoms with a combination of medication and physical therapy, many cases require surgical treatment. The goal of labral repair surgery is to repair the torn cartilage in the hip and restore its functionality rather than remove it, which often results in degenerative problems within the joint over time.
The procedure is usually performed using an arthroscopic approach, which allows the doctor to view the tear through a small camera and approach the site through tiny incisions using specialized tools. Larger tears or more complex injuries, however, may require an open procedure. The patient is given anesthesia and the surgery generally takes between two and four hours to complete, depending on the extent of the damage.
The labral repair procedure involves creating more space within the hip joint by trimming any damaged tissue and excessive bone in the area as needed. The tear is then sutured closed and repositioned, so the labrum can be securely reattached where it had pulled free from the bone. This is typically achieved with the use of anchors that are implanted in small holes that have been drilled into the bone and then attached to the labrum with sutures.
Recovery from Labral Repair Surgery
Labral repair surgery is usually very effective in treating labral tears and restoring full movement and strength to the hip joint. Most patients are released within a few hours following the procedure. A return to work may be possible within two weeks if the patient is mainly sedentary on the job. Athletes generally can resume playing sports four to six months after a labral repair procedure. Complete recovery time depends on the extent of the hip damage as well as the type of procedure performed, but usually takes several months.
An assistive device such as crutches is often necessary for a period of several days to two weeks to help patients walk comfortably without placing too much stress on the hip joint. Physical therapy is typically recommended to help strengthen the joint, improve mobility and promote faster healing.
Risks of Labral Repair Surgery
Labral repair surgery is generally a very safe and successful procedure, but all forms of surgery carry some risk of complications. The risks associated with labral repair procedures typically include nerve damage, injury to blood vessels, short-term numbness in the hip, infection and blood clots.