There are both nonsurgical and surgical treatment options for hip labral tears. Depending on the severity of the tear, surgery may be recommended right away. In other cases, surgery will be recommended only after nonsurgical interventions have been tried.
Nonsurgical Treatments for Hip Labral Tears
Hip labral tears can sometimes be treated with nonsurgical treatments. Below are some of the most common.
- Rest. Limited activity is advised to control discomfort, including the activities that bring on hip pain.
- NSAIDs. Taking non-steroidal anti-inflammatory drugs, such as aspirin or ibuprofen, for a limited period may reduce inflammation and pain in the hip area.
- Injections. A doctor may recommend local anesthetic fluid injections directly into the hip joint, called an intra-articular injection, if the pain is not alleviated from other measures. A corticosteroid may be added to the injection depending upon the level of hip pain and any other existing hip problems.
- Physical Therapy. A licensed physical therapist can provide an individual treatment plan. The plan may focus on strengthening the buttocks, thigh, and back, while also improving hip stability. Physical therapy for hip labral tears is considered a safe but under-studied treatment.1 Individuals should consult their doctor before beginning any physical therapy regimen.3
If these treatment options fail to relieve symptoms within 10 to 12 weeks, a doctor may recommend surgery.
Surgical Treatment for Hip Labral Tears
If nonsurgical treatments are not recommended, or if they have been tried and do not relieve the hip pain, surgery may be suggested. The type of procedure that will be performed is dependent upon the severity of the tear.
Most surgical options for labral repair are minimally invasive, using a tool called an arthroscope. The arthroscope is about the size of a pencil and equipped with a tiny television camera, allowing the surgeon to view and repair the damaged labrum without having to make a large incision.
- Arthroscopic labral debridement. This technique involves trimming or smoothing the area of the labrum that is torn, usually performed through an arthroscopic procedure. This procedure may be recommended if the surgeon believes that a frayed labrum is causing symptoms or could cause future symptoms.
- Arthroscopic hip labral repair. This may be recommended when the labrum has separated from the bone. During a labral repair, the doctor will reattach the torn labrum to the hip’s socket (acetabulum) using small metal or plastic “anchors” and sterile thread.
- Arthroscopic hip labral replacement. Labral replacement, sometimes called labral reconstruction, may be recommended when the labrum is too damaged to repair.
Labral replacement uses a graft (tissue from another part of the body or from a donor) to completely replace the torn labrum. This is a relatively new procedure and not considered standard practice. Physicians report promising outcomes3 but no large, long-term studies are currently available.
Arthroscopic surgery cannot always be performed. Bony abnormalities (such as those seen in hip impingement) or other hip conditions may make it difficult for a surgeon to access the hip joint with an arthroscope. In these cases a doctor may suggest an open surgical procedure that requires dislocating the hip.
- Surgical hip dislocation. In this approach, an “X” incision is made in the skin over the hip joint, and the femoral head is dislocated from its socket. This procedure provides a full view of the hip and is designed so that the surgeon can repair or replace the torn labrum and address other existing conditions, such as hip impingement.
Recovery time and long-term effects of the surgery will depend on many factors, including the type of damage that was present in the hip as well as the patient’s age. The general rule is that weight bearing is limited for 4 to 6 weeks and a custom rehabilitation protocol should begin soon after the procedure. Many people can eventually return to their usual, normal activities. Others may need to change from high-impact to low-impact activities, such as switching from running to cycling.4
If pain persists after these surgical interventions have been performed, a doctor may suggest hip arthroplasty, or hip replacement, as a next step.
It is becoming more common for sports injuries to be treated with regenerative medicine, such as platelet rich plasma or stem cell injections. Clinical studies on the use of regenerative medicine for hip labral tears have been relatively small with mostly inconclusive results. Large-scale studies are needed to determine how exactly regenerative medicine fits into hip labral tear treatments.
Regenerative medicine treatments are not considered standard practice and are unlikely to be covered by insurance.