Hip labral tears do not heal easily, so repair surgery may be necessary in many cases. The goal of surgery is to improve hip stability, function, and range-of-motion; decrease hip pain; and prevent additional damage to the hip joint.
When Do Doctors Recommend Hip Surgery to Repair a Torn Labrum?
A doctor may recommend hip labrum repair surgery if:
- The tear causes hip pain and other symptoms, and
- The tear has been confirmed using MRI or other medical imaging
For some labral tears, nonsurgical treatment may be tried before considering surgery. For example, a doctor may recommend physical therapy for several weeks, a hip joint injection, or a combination of both.
Labral tears with hip impingement
Depending on their level of pain and disability, even patients who have relatively small tears may be encouraged to consider surgery if they also have a condition known as femoroacetabular impingement, also known as FAI or hip impingement.
Hip impingement occurs when bony growths lead to abnormal contact between the hip’s bones. Research suggests that nonsurgical treatments have limited success for patients who have both a labral tear and hip impingement.1
Why labrums typically do not heal on their own
The hip labrum is made of tough fibrocartilage with a limited blood supply. Once it is torn from the bone, it is nearly impossible for it to re-attach itself and heal back to the bone without surgical intervention.
What is Done During Hip Labral Tear Repair Surgery?
During surgery a doctor may perform:
- Labral tear repair. The doctor will reattach the torn labrum to the socket (acetabulum) using small plastic “anchors” and sterile thread.
- Debridement. This technique involves trimming or smoothing the area of the labrum that is frayed. The goal is to remove loose, damaged and pain-generating tissue.
- Other repairs. Hip problems are often intertwined, so it is common for a surgeon to repair the hip labrum and address other problems during the same surgery. For example, the surgeon may repair the labrum and shave down bony abnormalities that cause hip impingement.
The decision to do other repairs may be made during surgery. Pre-operative medical imaging cannot always reveal everything that is wrong in a joint. A surgeon may confirm or discover other hip problems for the first time during surgery.
Arthroscopic vs. open hip surgery
Hip labral repair may be done using arthroscopic or open surgical methods.
- Hip arthroscopy is considered a minimally invasive surgery. Special surgical tools and a video camera are inserted through 2 to 4 incisions that are approximately 1 cm long.
- Open hip surgery requires a single incision 8 cm to 10 cm long. During open surgery, the surgeon may dislocate the femoral head from the hip socket. It is considered a major surgery.
Whether a person undergoes open or arthroscopic surgery depends on upon surgeon’s comfort level addressing a particular patient’s hip problems. These days, all labral issues can be addressed arthroscopically. Arthroscopic hip surgery has a shorter recovery period compared to open surgery.