Hip Labrum Surgery Recovery (2022)

Hip Labrum Surgery Recovery (1)

Hip pain can be debilitating eroding one’s function and quality of life. What is the hip labrum? What is hip labrum surgery? What is hip labrum surgery recovery? Let’s dig in.

(Video) Hip arthroscopy surgery: femoral acetabular impingement, labral repair | Ohio State Medical Center

What is Hip Labrum?

The hip joint is a ball-socket joint with the acetabulum being the shallow socket. The labrum is a ring of fibrocartilage and connective tissue attached to the acetabulum. The labrum provides support to the hip, deepens the shallow joint and increases the surface area of the acetabulum by 28% (1). Tears in the hip labrum can occur as a result of direct trauma and activities that require external rotation such as soccer, hockey, and golf. Unfortunately, up to 74% of all hip labrum tears are not associated with any known specific cause or event (2). Labral tears are reported more in females than males (3).

Pain can be a common complaint typically localized in the anterior hip or groin. Other mechanical symptoms may be present which include clicking, locking or giving away.

What is Hip Labrum Surgery?

Hip labrum surgery involves the insertion of a narrow-gauge camera and operating instruments into the hip joint. This is called arthroscopy and allows the surgeon to visualize structures inside of the hip joint including the labrum. Small labral tears are some times “repaired” with stitches. More commonly there is debridement which involves removing a portion of the labrum. There has been a rapid increase in the number of hip arthroscopies in the United States over the last 20 years. From 2007 to 2014 the number increased by 117% (4). The insertion of the surgical camera and instruments into the small, tight hip joint requires partial dislocation of the joint by means of a traction table. The most common complication of hip labrum surgery is nerve damage with an incidence of 16.5% (5). Nerve damage is more common in women than men and increases with longer traction times.

Post Surgery Guidelines

Hip labrum surgery recovery involves rehabilitation which is divided into four phases.

(Video) Hip Labral Reconstruction

  • Phase 1: weeks 1-4: 50% partial weight-bearing for 10 days or more and light strengthening. The goal is to minimize inflammation, protect the surgically repaired tissue and control pain. Narcotics are frequently needed.
  • Phase 2: weeks 5-7: Focus is to improve range of motion and flexibility through extensive physical therapy.
  • Phase 3: weeks 8-12: Focus is on symmetrical range of motion and integrated functional strengthening. Multi-planar movements and strengthening with multiple muscle groups are important.
  • Phase 4: weeks 12 and beyond: Focus is on safe return to competition or previous activity level utilizing manual therapy, flexibility, and range of motion exercises.

Little evidence exists in the current literature to support rehabilitation procedures after hip labrum surgery (6). Twelve weeks of extensive physical therapy and strengthening is a significant investment in time and money. This is in addition the downtime due to pain and immobility that patients experience.

Is Hip Labrum Surgery Successful?

A recent study at Mayo Clinic followed 57 patients who underwent surgery for labral tears. An alarming 45% of patients had poor clinical results at an average of 5 years after the surgery (7). 20% of patients required additional surgery. In a different study, 80 patients with documented labral tears were randomized to undergo surgical repair or physical therapy. At 2 years there was no difference in outcomes between the two groups. Hip labral surgery was no better physical therapy (8). In a review of multiple research studies examining pain and hip function after hip surgery for patients with FAI, authors demonstrated more pain and less function in the surgical group as compared to nonsurgical counterparts (9).

Another important concern is whether or not labral tears cause pain. A 2013 study looked at the MRIs of 85 patients with hip pain and found no association between pain and labral tears (10). A different study followed professional Danish ballet dancers. It demonstrated that those with pain while dancing had no more evidence of labral tears on MRI than those dancers without hip pain (11). Is it possible to have a labral tear and no pain? Yes! Another study looked at 45 patients, with an average age of 38 years with no hip pain and found that 69% had labral tears (12).

Hip Labrum Surgery Alternative

(Video) Setup and Distraction: Labral Repair of the Hip, featuring the SPEEDLOCK™ Hip with Mr Tony Andrade

Non-Surgical Treatment Options

Platelet-rich plasma (PRP) injections have been effective in the treatment of labral tears with a reduction of pain and improved function at 8 weeks (13). Bone marrow-derived stem cells injected into labral tears have also resulted in a reduction in pain (14). At the Centeno-Schultz Clinic, we pioneered orthopedic stem cell injections and have extensive experience in the treatment of hip labral tears. The injection of a labral tear is not a procedure that your family physician, or surgeon, can perform.. The labrum is a small structure and demands significant skill and training to inject. All injections are performed under x-ray or ultrasound guidance or both. To better understand the complexity of stem cell injections in the labral please click on the video below.

https://www.youtube.com/watch?v=Gdrwf2-Tw8I

To Conclude…

The hip labrum is a ring of fibrocartilage that provides support and reduces stress within the hip joint. It is susceptible to injury and often with no specific event or trauma. The presence of a labral tear on MRI is not correlated with pain. Surgery involves repair or excision of the damaged tissue and has become increasingly popular. Traction is required and is associated with nerve injuries. Studies have demonstrated labral surgery to be no better than PT and reduced function. Platelet-rich plasma and stem cells are effective treatment options without the associated risks, extensive rehabilitation and complications associated with surgery.

https://centenoschultz.com/hip-labral-tear-surgery-success-rate/

(Video) Hip labral tear surgery recovery - basketball after failed physical therapy and hip surgery?

References

  1. Tan V, Seldes RM, Katz MA, Freedhand AM, Klimkiewicz JJ, Fitzgerald RH. Contribution of acetabular labrum to articulating surface area and femoral head coverage in adult hip joints: an anatomic study in cadavera.Am J Orthop.2001;30(11):809-12.
  2. Santori N, Villar RN. Acetabular labral tears: result of arthroscopic partial limbectomy.Arthroscopy.2000;16(1):11-5.DOI:10.1016/s0749-8063(00)90121-x
  3. Dorrell JH, Catterall A. The torn acetabular labrum.J Bone Joint Surg Br.1986;68(3):400-3.
  4. Truntzer JN, Shapiro LM, Hoppe DJ, Abrams GD, Safran MR. Hip arthroscopy in the United States: an update following coding changes in 2011.J Hip Preserv Surg.2017;4(3):250-7.doi:10.1093/jhps/hnx004
  5. Larson CM, Clohisy JC, Beaulé PE, et al. Intraoperative and Early Postoperative Complications After Hip Arthroscopic Surgery: A Prospective Multicenter Trial Utilizing a Validated Grading Scheme.Am J Sports Med.2016;44(9):2292-8.DOI:10.1177/0363546516650885
  6. Garrison JC, Osler MT, Singleton SB. Rehabilitation after arthroscopy of an acetabular labral tear.N Am J Sports Phys Ther.2007;2(4):241-50.
  7. Krych AJ, Kuzma SA, Kovachevich R, Hudgens JL, Stuart MJ, Levy BA. Modest mid-term outcomes after isolated arthroscopic debridement of acetabular labral tears.Knee Surg Sports Traumatol Arthrosc.2014;22(4):763-7.DOI:10.1007/s00167-014-2872-1
  8. Mansell NS, Rhon DI, Marchant BG, Slevin JM, Meyer JL. Two-year outcomes after arthroscopic surgery compared to physical therapy for femoracetabular impingement: A protocol for a randomized clinical trial.BMC Musculoskelet Disord.2016;17:60.doi:10.1186/s12891-016-0914-1
  9. Kierkegaard S, Langeskov-Christensen M, Lund B, et al. Pain, activities of daily living and sport function at different time points after hip arthroscopy in patients with femoroacetabular impingement: a systematic review with meta-analysis.Br J Sports Med.2017;51(7):572-9.DOI: 10.1136/bjsports-2016-096618
  10. Krych AJ, Kuzma SA, Kovachevich R, Hudgens JL, Stuart MJ, Levy BA. Modest mid-term outcomes after isolated arthroscopic debridement of acetabular labral tears.Knee Surg Sports Traumatol Arthrosc.2014;22(4):763-7.DOI:10.1007/s00167-014-2872-1
  11. Duthon VB, Charbonnier C, Kolo FC, et al. Correlation of clinical and magnetic resonance imaging findings in hips of elite female ballet dancers.Arthroscopy.2013;29(3):411-9.DOI:10.1016/j.arthro.2012.10.012
  12. Register B, Pennock AT, Ho CP, Strickland CD, Lawand A, Philippon MJ. Prevalence of abnormal hip findings in asymptomatic participants: a prospective, blinded study.Am J Sports Med.2012;40(12):2720-4.DOI:10.1177/0363546512462124
  13. De Luigi AJ, Blatz D, Karam C, Gustin Z, Gordon A. Use of Platelet Rich Plasma for the Treatment of Acetabular Labral Tear of the Hip: A Pilot Study.Am J Phys Med Rehabil.[published online: May 30, 2019]. 10.1097/PHM.0000000000001237
  14. Garwood ER, Burke CJ, Jazrawi LM, Adler RS. Percutaneous Ultrasound-Guided Musculoskeletal Applications of Autologous Bone Marrow Aspirate Concentrate: Preliminary Experience From a Single Institution.Ultrasound Q.2018;34(4):278-84.DOI:10.1097/RUQ.0000000000000339

FAQs

Is it easy to Retear your hip labrum after surgery? ›

Once the labrum has been repaired and all bony impingement has been corrected there is a very small chance that the labrum will re-tear. However, if the labrum is repaired without removing the bony impingement there is a high likelihood that the labrum will tear again.

How long is recovery from surgery on a torn labrum in the hip? ›

How Long Does Hip Labral Tear Recovery Take? After a hip labral tear surgery, most patients spend four months in one-on-one physical therapy sessions and can then ease back into their everyday activities subsequently. However, it can take them up to nine months to get back to their hundred percent.

What is recovery like after hip labrum surgery? ›

Hip arthroscopy patients can expect to walk using crutches for 1-2 weeks afterward, and to undergo six weeks of physical therapy. It may be 3-6 months before they experience no pain after physical activity. Below is some guidance on ways to expedite the recovery and healing process.

How do I know if my hip arthroscopy failed? ›

Failed hip arthroscopy may be defined as persistent postoperative pain and/or stiffness—diagnosed by a combination of decreased joint capacity and global range of motion (ROM)—that does not improve with nonsurgical means [5].

How fragile is a labrum repair? ›

Labral repair is somewhat fragile in the early stages of postop healing, and therefore recovery is longer and slower than labral debridement. What happens if my labral tear is not repairable? In most cases, the torn labrum is repairable.

Why does my hip still hurt after labrum surgery? ›

The most common factors that can lead to persistent pain AFTER hip arthroscopy include things that were likely present BEFORE the hip arthroscopy: obesity, low back pain, S.I. Joint pain, Piriformis Pain, muscle imbalances, referred pain and pelvic pain from a variety of causes.

How soon can you walk after hip labrum surgery? ›

For most procedures you are able to begin a gradual weight bearing progression at 2 weeks, and may be able to discontinue use of crutches 3 weeks after surgery. For some procedures you may be on crutches for as long as 6‐8 weeks.

What can you not do after hip labrum surgery? ›

Avoid putting too much weight on your leg and lifting the leg up. Your surgeon recommends avoiding active hip flexion (lifting your leg up at the hip) until 2-3 weeks after your surgery. This precaution is to prevent excessive hip flexor tendonitis after your surgery.

Is hip arthroscopy worth it? ›

Arthroscopic hip surgery undoubtedly plays an important role in the treatment of hip labral injuries. That said, many patients can find equally effective treatment with nonsurgical treatment. In almost all scenarios, nonsurgical treatment should be attempted before considering arthroscopic surgery.

How long does pain last after hip labrum repair? ›

In most cases, you should be able to walk relatively free of pain about six to eight weeks following surgery. However, it could take three to six months or more to get back to an elite level of fitness. You can treat any unexpected increase in pain with ice and anti-inflammatory medicine.

How do you sit after hip labrum surgery? ›

When sitting, try to sit with the hips at 90 degrees. Sitting with the knees closer to the chest might produce pain or pinching at the hip. Limit prolonged standing and walking up to four weeks after surgery to avoid hip discomfort. Avoid deep squatting or heavy lifting up to six weeks after surgery.

Why do I still have pain after hip arthroscopy? ›

The major etiologies for persistent pain after hip arthroscopy fall into the following five major categories: femoroacetabular impingement (FAI); instability; arthritis; other intra-articular pathologies; and extra-articular factors.

How do I know if I re injured my hip labrum after surgery? ›

Hip labral tear symptoms can include:
  1. Deep groin pain or pain in the buttocks on the side of the injured hip.
  2. A feeling or sound of clicking or locking when your hip is in motion.
  3. Hip pain, especially while it rotates in certain directions.
  4. Stiffness while moving your hip.

How do I know if I injured my hip labrum after surgery? ›

Hip labral tear symptoms include: Pain in the hip, groin or buttocks, especially as you walk or run, and sometimes at night when you sleep. Hip stiffness or limited range of motion. A clicking or locking sensation in the hip joint when you move.

Why do hip arthroscopy procedures fail? ›

Conclusions. Residual or unaddressed structural deformity of the hip and underlying osteoarthritis are commonly associated with failure after hip arthroscopy.

How risky is labrum surgery? ›

Potential complications of labrum repair

Incomplete repair or postoperative failure. Instrument breakage during surgery. Joint stiffness or damage to other joint structures. Nerve damage.

How long are you in pain after labrum surgery? ›

It requires about 6 to 8 weeks to heal to the bone. During that time the less stress you put across the shoulder, the more likely it is for the labrum to heal. You will be allowed to move the arm gently with assistance. This is called passive motion, where the other arm or someone else helps move the operative arm.

Can labrum surgery failed? ›

A labral retear is an important contributing factor to surgical failure after arthroscopic soft tissue stabilization for recurrent anterior shoulder instability. However, surgeons frequently encounter poor tissue conditions in the anterior capsule, such as capsular tears, during revision surgery.

Can labral anchors come out? ›

As we mentioned in a previous post, most suture anchors stay in your bone for life. The technology has advanced to such a degree, that they are extraordinarily reliable and rarely come out.

How long should I have pain after hip arthroscopy? ›

You may feel hip pain on the side of surgery for a while after the procedure, but it should significantly diminish or disappear in three to six months. Your doctor will prescribe pain medications to help with pain during recovery. If your pain increases or feels like it's sharp or stabbing, discuss it with your doctor.

Is it normal to have groin pain after hip arthroscopy? ›

Persistent groin pain after open and arthroscopic impingement surgery can be due to insufficient correction of the femoral and acetabular pathology, advanced joint degeneration with joint space narrowing, cartilage damage [2, 4, 11, 16]. It is also sometimes associated with resection of the labrum [5].

Can you make a hip labral tear worse? ›

If you have a hip labral tear, hip pain or discomfort may get worse when you bend, move or rotate the hip, or exercise or play sports.

What can you not do after hip labrum surgery? ›

Avoid putting too much weight on your leg and lifting the leg up. Your surgeon recommends avoiding active hip flexion (lifting your leg up at the hip) until 2-3 weeks after your surgery. This precaution is to prevent excessive hip flexor tendonitis after your surgery.

Why do I still have pain after hip arthroscopy? ›

The major etiologies for persistent pain after hip arthroscopy fall into the following five major categories: femoroacetabular impingement (FAI); instability; arthritis; other intra-articular pathologies; and extra-articular factors.

How successful is hip impingement surgery? ›

The arthroscopic hip surgery success rate is around 85 to 90 percent. The operation is performed to help restore your hip's function, but it's most successful at easing pain. It's often difficult to return to vigorous use of the leg in sports or work.

Does walking make labral tear worse? ›

Many hip labral tears cause no signs or symptoms. Some people, however, have one or more of the following: Pain in the hip or groin, often made worse by long periods of standing, sitting or walking or athletic activity.

What aggravates a hip labral tear? ›

Many patients with labral tears describe a constant dull pain with intermittent episodes of sharp pain that worsens with activity. Walking, pivoting, prolonged sitting, and impact activities, such as running, often aggravate symptoms.

Can I ride a bike with a torn hip labrum? ›

Sadly, your loyal cross-training friend, cycling, is off-limits, too. “The most aggravating position for the hip labrum is hip flexion combined with other movements,” Yuen says. This is basically cycling, so the elliptical or pool are safer cardio options while you're recovering.

How do you sit after hip labrum surgery? ›

When sitting, try to sit with the hips at 90 degrees. Sitting with the knees closer to the chest might produce pain or pinching at the hip. Limit prolonged standing and walking up to four weeks after surgery to avoid hip discomfort. Avoid deep squatting or heavy lifting up to six weeks after surgery.

How long does it take to get off crutches after hip labrum surgery? ›

If a labral repair is done, crutches may be needed 4-6 weeks. During this first 4 to 6 week period you will be walking around very slowly and sore. At about 6 weeks, most patients are ambulating normally and you can gradually increase the hip range of motion above 90 degrees.

How do you sit on the toilet after hip arthroscopy? ›

You can sit on a toilet after hip arthroscopy as long as your hip does not flex more than 90 degrees while sitting. If your toilet seat is low, you may have problems getting up and down. In this case, using a riser designed to elevate the toilet seat will help you avoid discomfort or flexing the hip too much.

When can I sleep on my side after hip arthroscopy? ›

All hip arthroscopy patients are to be on their backs in bed for the first postoperative night - no prone (stomach) or side-lying sleeping during night 1!

How long should I have pain after hip arthroscopy? ›

You may feel hip pain on the side of surgery for a while after the procedure, but it should significantly diminish or disappear in three to six months. Your doctor will prescribe pain medications to help with pain during recovery. If your pain increases or feels like it's sharp or stabbing, discuss it with your doctor.

Is it normal to have groin pain after hip arthroscopy? ›

Persistent groin pain after open and arthroscopic impingement surgery can be due to insufficient correction of the femoral and acetabular pathology, advanced joint degeneration with joint space narrowing, cartilage damage [2, 4, 11, 16]. It is also sometimes associated with resection of the labrum [5].

Is hip arthroscopy worth it? ›

Arthroscopic hip surgery undoubtedly plays an important role in the treatment of hip labral injuries. That said, many patients can find equally effective treatment with nonsurgical treatment. In almost all scenarios, nonsurgical treatment should be attempted before considering arthroscopic surgery.

Why do hip arthroscopy procedures fail? ›

Conclusions. Residual or unaddressed structural deformity of the hip and underlying osteoarthritis are commonly associated with failure after hip arthroscopy.

How soon can you walk after hip labrum surgery? ›

For most procedures you are able to begin a gradual weight bearing progression at 2 weeks, and may be able to discontinue use of crutches 3 weeks after surgery. For some procedures you may be on crutches for as long as 6‐8 weeks.

Videos

1. Michaela's Story - College Volleyball Player Has Labral Repair On Both Hips
(Panorama Orthopedics & Spine Center)
2. Madison Packer Discusses Hip Arthroscopy for Hip Labral Tear
(NYU Langone Health)
3. Hip Arthroscopy Labral Tear Repair Surgery / Week 1 Post Op / Running hip injury recovery - Ep. 2
(UltraTrailSteven)
4. Hip Arthroscopy Labral Repair Surgery: Day of Surgery/Recovery Day 1
(Holly Bollig)
5. Is surgery for a hip labral tear worth it? Jawn's journey with hip pain
(Upright Health)
6. POST SURGERY DAY 1 Right Hip Arthroscopy/Labrum Repair/FAI
(Arika Kay)

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