A hip labral tear is a painful condition that may require surgery. The hip labrum is a rubbery cartilage that has several important functions. One of these important functions is to help keep the ball part of the hip joint (top of the femur) in the socket (part of the pelvis). There are several causes of hip labral tears. Some causes are a result of trauma. However, there are also several non-traumatic causes of hip labrum tears. Traumatic tears of the hip labrum most commonly occur during high impact sports or exercise. On the other hand, non-traumatic hip labral tears are usually attributed to several biomechanical factors. The treatment for hip labral tears will depend on a number of variables, including the cause and severity of tear. Arthroscopic surgery is the best option in some cases; but not all cases. This article outlines how hip larbal tears can occur, some alternatives to surgery, what happens during arthroscopic hip labral tear repairs, as well as the risks, and expected recovery time after surgery.
People with hip labral tears may be advised to try a conservative approach at first. This may include avoiding any aggravating activities (such as sport), anti-inflammatory medications, pain medications, and perhaps most importantly undertaking physical therapy for approximately 12 weeks. For many people, the symptoms may subside with this approach only to return once they begin undertaking their usual activities. Steroid injections may be considered but are generally not the first treatment option for young people who otherwise do not have degeneration at the hip joint.
If conservative management has not resulted in a suitable reduction in symptoms, surgery is sometimes considered. The earlier surgical techniques would simply cut away the damaged portion of the labrum. However, the removal of hip labrum may contribute to hip instability and earlier onset of arthritis. Therefore, contemporary surgical approaches most often include arthroscopic repair of the hip labrum. This involves making several small incisions (also colloquially known as 'keyholes') and inserting surgical instruments to access the hip joint with minimal invasiveness. Although, it is worth noting that even arthroscopic hip labrum repairs (as with all surgery) is still an invasive procedure. Once the instruments are in place, the surgeon can use several techniques to tidy up the area and repair structural abnormalities. The purpose of arthroscopic treatment is to relieve pain by eliminating the unstable flap tear that causes the discomfort. In some cases open surgery may be required, which involves the surgeon cutting through the skin and soft tissues to directly access the hip joint and repair the affected structures. Open procedures are generally more invasive, painful and have a longer recovery time. For this reason they are typically only used when arthroscopic surgery is not viable or likely to be successful (not common for hip labral tears these days).