Hip Labral Reconstruction

What is Hip Labral Reconstruction?

Hip labral reconstruction is a surgical procedure designed to restore the labrum, which is a ring of cartilage that lines the hip socket providing stability to the hip joint. Hip labral reconstruction may be indicated for cases where the labrum is too damaged for a hip labral repair. This may be due to conditions like femoroacetabular impingement (FAI), previous injury, or degeneration. Labral reconstruction uses either your own or donor graft tissue to replace the damaged labrum that is not amendable for repair. This procedure can help restore normal joint mechanics, alleviate pain, and improve function

Why is Labral Reconstruction Needed?

Labral tears that cannot be repaired or are associated with significant damage may be indicated for a labral reconstruction. Labral reconstructions are more common after revision hip arthroscopy procedures. If left untreated, these tears can increase the risk of osteoarthritis. Labral reconstruction aims to restore the function of the labrum, ensuring the smooth movement of the hip and preserving the joint’s long-term health.

How will I know if I need a Hip Labral Reconstruction?

A comprehensive evaluation, including physical examination, medical history, and imaging studies (usually MRI), helps confirm the diagnosis of a labral tear and will help guide the decision if reconstruction is necessary. Diagnostic injections may also be used to localize pain and guide treatment decisions. However, the final decision to perform a labral reconstruction is made during the procedure once we see if the labrum is too damaged to repair.

Treatment Options

What are the Treatment Options for Labral Tears?

Treatment options for labral tears include both non-operative and surgical interventions.

Non-Operative Management:

For less severe cases, non-operative management may be effective. This can include:

• Physical Therapy: Focuses on strengthening the muscles around the hip to improve stability, enhance range of motion, and reduce pain.
• Activity Modification: Patients may be advised to avoid activities that worsen their symptoms, such as running or jumping, and switch to low-impact exercises like swimming.
• Pain Management: Anti-inflammatory medications or injections may be used to control pain while the hip is rehabilitated.

Surgical Management:

For patients with extensive labral damage or those who do not respond to conservative treatments, surgical intervention may be necessary.

Hip Arthroscopy and Labral Reconstruction:

Hip arthroscopy is a minimally invasive procedure to access the hip joint using small incisions and specialized instruments. During the labral reconstruction, the labrum is reconstructed using tissue grafts (either from the patient or a donor). The reconstructed labrum is secured to the bone with anchors in order to help restore stability and function.

Key aspects of the procedure include:

• Labral Reconstruction: A graft is used to replace the damaged labrum when it cannot be repaired.
• FAI Correction: If necessary, bony impingements are removed by reshaping the femoral head or the acetabulum to prevent further damage.
• Capsular Plication: Tightening of the joint capsule to reduce excessive movement and improve stability.

Rehabilitation after Labral Reconstruction:

Postoperative rehabilitation is critical for a successful recovery. Physical therapy typically begins soon after surgery, focusing on restoring range of motion, improving strength, and gradually increasing weight-bearing activities. Full recovery can take several months, with most patients returning to their normal activities around 4-6 months, possibly 1 year for maximal recovery.

Dr. Shane J. Nho is a board-certified fellowship-trained sports medicine orthopedic surgeon who specializes in the treatment of hip labral tears. For more information on hip labral reconstruction or to schedule a consultation, contact our orthopedic team today.