Hip Labral Repair

A hip labral tear is often the result of overuse in sports. The labrum can become torn for a variety of reasons.  The labrum can be injured or torn because of a traumatic, acute injury (such as a hip subluxation or dislocation that occurs during competitive sports) or through a chronic, degenerative process that results in tearing related to years of repetitive small injuries.

The labrum is the soft, flexible tissue that surrounds and covers the rim of the hip socket (known as the acetabulum).  The labrum exists to provide stability to the hip joint and is critical in distributing load throughout the cartilage.  Athletes who participate in sports (such as golf, ice hockey, soccer, and football) where powerful rotations and forceful pivots occur are at the highest risk for developing a labral tear. This type of injury can be a major source of hip pain and weakness for athletes. Symptoms include hip weakness, hip pain, or a “catching” sensation within the hip joint.

Dr. Padalecki will assess the hip joint by conducting a physical examination, as well as taking a deeper look at the joint either through an X-ray or an MRI. Initial treatment may include pain relievers and physical therapy.  If conservative measures do not heal the torn labrum and resolve the symptoms over a specified period of time, Dr. Padalecki will treat the injury using an arthroscopic surgical approach.

Arthroscopic hip surgery to repair the labrum of a hip has advanced in recent years and is becoming a popular treatment choice among surgeons.  It has been noted to consistently yield positive outcomes for patients. Using arthroscopic techniques, which include small incisions and the insertion of a tiny camera and surgical tools, Dr. Padalecki will enter the hip joint and assess the injury. He will remove the loose fragments from within the joint and trim or repair the labral tear. This involves shaving and smoothing out the torn portion of the labrum (debridement) and reattaching the healthy segments with suture anchors (repair).

Depending on the size of the labral tear, Dr. Padalecki may implement a number of different approaches during the actual repair procedure. In larger and more complex cases that include cartilage damage, he may choose to use a labral fixation approach.  This involves using specialized sutures and bioabsorbable anchors to complete the repair process. Alternatively, he may use a technique known as a labral reconstruction procedure for chronic cases where the labrum is so severely damaged that it is unable to be repaired.  During this procedure, he will use a graft to reconstruct the damaged labrum.  This graft will come either from the patient’s fascia or a cadaver. The goal of labral reconstruction surgery is to restore the functional anatomy of the native labrum, restore the normal biomechanics of the hip, and prevent further damage to the articular cartilage.

Post-op recovery following a hip labral repair will depend on the complexity of the surgery.  Following arthroscopic surgery, the patient will be given a strict rehabilitation protocol to follow with a skilled physical therapist. Depending on the exact nature of the surgery, once physical therapy has been completed, most athletes are able to return to sports within 4-6 months.

For additional information on labral tears of the hip, or to inquire about arthroscopic hip surgery for labral repairs of the hip, please contact the Austin, Texas orthopedic office of Dr. Jeff Padalecki.