The acetabular labrum is a type of cartilage that covers the rim of the hip socket (known as the acetabulum). It may be injured as a result of a sports accident or an acute injury such as a hip dislocation or subluxation. It also can be injured gradually with time in settings of femeroacetabular impingment. The labrum exists to provide stability to the hip joint mainly by creating a negative pressure seal at the hip, this aids smooth hip motion and flexibility. Damage to the labrum may be a major source of hip pain and weakness for athletes. However, not all labral tears are associated with hip pain. Some studies have shown that they may exist in patients without pain/dysfunction at the hip.
If a acetabular labral tear is identified, it is important to determine that it is associated with pain from the hip joint. When a labral tear is identified, strengthening the muscles around the hip joint will improve function and decrease pain in most instances. If initial strengthening measures do not improve a patient’s symptoms, Dr. Anz may recommend a hip labral repair using hip arthroscopy. During this procedure, Dr. Anz will use a small camera and tiny instruments to enter the hip and view the acetabular labrum and surrounding structures. Treatment for the actual tear will involve shaving and smoothing out the torn portion of the labrum (debridement) and/or reattaching healthy segments with sutures (repair). Repair involves sutures (strong string-like material) and absorbable anchors (strong screw-like implants) which have been developed specifically for the hip. The sutures and anchors are used to secure the labral tissue to the base of the acetabulum.
In some situations the labral tissue may be damaged beyond repair. This can occur in scenarios where femeroacetabular impingment has been present for many years. In these instances, Dr. Anz may perform reconstruction of the labral tissue using a graft. The graft will come from the patient or from a cadaver in order to reconstruct the damaged labrum. The goal of labral repair or reconstruction surgery is to restore the negative pressure seal which the labrum creates, thus restoring near-normal biomechanics of the hip.
Following hip labral repair surgery, Dr. Anz will prescribe a week-by-week rehabilitation protocol to follow. This will be a progressive process where the patient works with a therapist to regain full range of motion and strength back to the hip joint. Depending on the exact nature of the surgery and complexity of the injury, recovery is estimated at 4-6 months.
For additional information on labral tear repair surgery, or to learn more about arthroscopic hip surgery, please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute.