Hip Labral Tear Treatment Options

What are my options?

Patients typically either undergo conservative non-operative management or surgical management. Deciding which is best for you depends specifically on the patient and their unique characteristics and circumstances.

What non-operative treatment options are there?

Physical therapy is a cornerstone of non-surgical management for hip labral tears. The primary goal of physical therapy is to reduce pain, improve hip function, and enhance overall joint stability. Here’s how physical therapy can help:

1. Strengthening Exercises: Customized exercises aim to fortify the muscles around the hip joint, including the abductors, adductors, flexors, and extensors. Enhancing muscle strength and control helps stabilize the hip joint and alleviate symptoms associated with labral tears.
2. Range of Motion Exercises: Gentle stretching and mobilization routines are included to boost hip joint flexibility and reduce stiffness. Improved range of motion facilitates smoother joint movement and lessens discomfort during everyday activities.
3. Core Stability Training: Core strengthening exercises focus on the muscles of the abdomen, pelvis, and lower back, which are vital for maintaining hip stability and proper biomechanics. A strong core distributes forces more efficiently, reducing strain on the hip joint and easing symptoms of labral tears.
4. Functional Movement Training: Exercises that mimic real-life movements and activities improve coordination, balance, and proprioception. By enhancing dynamic stability and movement control, functional training lowers the risk of injury and enhances overall functional capacity.
5. Self-Management Strategies: Patients are educated on proper body mechanics, activity modification, and self-management techniques to optimize their recovery and prevent the recurrence of symptoms. Providing individuals with the knowledge and skills to manage their condition effectively is crucial for long-term success.

Activity Modification

Modification of activities that exacerbate hip instability is essential to prevent further damage and promote healing. Patients may be advised to avoid high-impact activities such as running or jumping and to engage in low-impact exercises such as swimming or cycling. Additionally, proper warm-up and stretching exercises before physical activity can help reduce the risk of injury.

Pain Management

Non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to alleviate pain and inflammation associated with hip instability. These medications can provide temporary relief while other conservative measures are implemented.

Hip Arthroscopy

Arthroscopic hip surgery is a minimally invasive surgery done through 3 small incisions with a camera and small tools that allow for the precise and methodical repair of the labral without damaging major muscular and neurovascular structures surrounding the hip joint. This technique allows Dr. Shane J. Nho to visualize the inside of the joint and address various abnormalities, including:

• Labral Repair: Repair of labral tears or debridement of damaged tissue to restore normal hip joint mechanics and stability.
• Labral Reconstruction and Augmentation: In cases when the labrum is deficient or is unable to be repaired, Dr. Shane J. Nho can reconstruct or enhance the labrum through use of one’s own tissue or donor tissue.
• Capsular Plication: Tightening of the hip joint capsule to reduce excessive joint movement and improve stability.
• Impingement Correction: Removal of bony impingement or reshaping of the hip joint structures to alleviate impingement and prevent further damage to the labrum.

Open Surgical Procedures

In some cases, open surgical procedures may be necessary, particularly for complex or severe cases of hip instability. These procedures may involve:

• Periacetabular Osteotomy: Surgical realignment of the pelvis to improve hip joint stability and reduce the risk of dislocation, particularly in cases of hip dysplasia.
• Hip Replacement: In severe cases of hip impingement or advanced arthritis and irreparable joint damage associated with a labral tear, total hip replacement surgery may be considered to restore function and alleviate pain.

What does rehabilitation look like?

Rehabilitation following surgical intervention is crucial for optimizing outcomes and restoring function to the hip joint. Physical therapy is typically initiated the day after surgery to promote healing, improve joint mobility, and gradually reintroduce weight-bearing activities. The rehabilitation process may involve a progressive exercise program, manual therapy techniques, and patient education on proper body mechanics and activity modification to prevent recurrence of labral tears.

In conclusion, the treatment of hip labral tears requires a comprehensive approach that addresses the underlying cause, alleviates symptoms, and restores stability and function to the hip joint. Conservative measures such as physical therapy, activity modification, and pain management may be effective for mild to moderate cases, while surgical intervention may be necessary for more severe or complex conditions.

Dr. Shane J. Nho is a board-certified fellowship-trained sports medicine orthopedic surgeon who specializes in the treatment of hip labral tears. If you believe you are affected by a hip labral tear, schedule a consultation today with our experienced orthopedic care team.