Labral Repair

Labral repair

Labrum is a ring of strong fibrocartilaginous tissue lining around the socket of the hip joint. Labrum serves many functions where it acts as shock absorber, lubricates the joint, and distributes the pressure equally. It holds the head of the femur in place and prevents the lateral and vertical movement of the femur head with in the joint. It also deepens the acetabular cavity and offers stability against femoral head translation.

Labral tear may be caused by trauma, femoroacetabular impingement (FAI), hip hypermobility, dysplasia, and degeneration. It is one of the rare conditions and is common in athletes playing sports such as ice hockey, soccer, golf and ballet. Structural abnormalities may also cause hip labral tear. Patients may have hip pain, clicking and locking of joint and restricted range of motion. Patients may also experience dull pain on movement of hip joint that may not subside on rest. Hip labral tear is often diagnosed with symptoms, history, physical examination and radiological techniques. Magnetic resonance arthroscopy may be more appropriate for diagnosing hip labral tear.

Your doctor may start with conservative treatment prescribing nonsteroidal anti-inflammatory drugs and advising you to rest. These methods may offer symptomatic relief while surgery is required to repair the torn labrum. Your doctor may perform arthroscopic surgery using fiber-optic camera and surgical instruments through the smaller incisions. Depending on the severity of tear, the damaged or torn labrum may be removed or may be sutured.

Surgical Treatment

If a patient fails nonsurgical treatment, and is an appropriate surgical candidate, then hip arthroscopy may be the next step. This involves small portal incisions in the skin and specialized instruments to evaluate the joint with a camera. Using specialized tools a labral tear can be identified and repaired with anchors and sutures. The anchors are non-metallic, and do not show on xray. The misshapen bone (FAI) is also corrected by shaving down the bumps with a small bone bur. Xray is utilized during the procedure to provide real-time feedback during the sculpting process.

Case Example #1

Intraoperative photo with suture passing device to repair hip labrum

Completed 3-anchor hip labral repair with restoration of chondrolabral seal

Case Example #2

Severely damaged and macerated labral tear in young athlete

4-anchor labral repair complete

Case Example #3

33yo active female runner with 9 months of hip pain preventing sport activity. After 6 months of failed nonsurgical treatment, patient elected for hip arthroscopy with labral repair.

Completed 4-anchor hip labral repair

 hip labral repair

Patient returned to running and sport activity 6 months after surgery with no pain

Hip Procedures