Hip Arthroscopy with Labral Repair

This procedure is commonly recommended for active individuals who have hip pain due to a labral tear or FAI that hasn’t responded to conservative treatments such as physical therapy, rest, or pain medication. It can also be considered for people who have persistent hip symptoms despite non-surgical interventions or those with significant hip joint damage. The timing of surgery depends on the individual patient’s symptoms, the extent of the impingement, and the presence of any underlying hip conditions.

Hip arthroscopy surgery is typically performed under general anesthesia. Your hip surgeon Dr. Mayo makes several small incisions around the hip, and an arthroscope is inserted, a small camera that provides a clear view of the hip joint. The camera is used to first inspect the hip joint to assess the condition of the labrum and the extent of FAI. In order to allow better visualization of the hip and move instruments, a cut in the hip capsule is made which is later repaired. Depending on the findings of the labrum, different procedures would be performed.

Hip Arthroscopy for Labral Repair

Labral repair is often the first choice for surgical treatment of a hip labral tear. In this procedure, your hip surgeon Dr. Mayo uses specially designed suture anchors to stitch the torn labrum back together, enabling it to heal in its natural position. This procedure is most suitable for patients with a healthy, robust labrum that is torn but not significantly degenerated.

Hip Arthroscopy for Labral Debridement

In cases where the labrum is frayed and degenerated, Dr. Mayo may choose to clean or trim the damaged tissue away in a procedure known as debridement. Debridement is usually recommended for older patients or those with significant degenerative changes in the hip joint, where the tissue quality is not suitable for a successful repair. Debridement may offer quicker recovery times compared to labral repair but may not provide the same level of long-term joint stability.

Hip Arthroscopy with Labral Reconstruction

If the labrum is too damaged for repair or debridement, it may need to be reconstructed. Labral reconstruction involves replacing the damaged labrum with a graft, which can be taken from elsewhere in the patient’s body (autograft) or from donor tissue (allograft). This surgery aims to restore the normal anatomy and function of the hip joint. It is generally considered for younger, active patients who have had a failed previous hip preservation surgery (like a labral repair) or where the labrum is not repairable. The recovery process is usually longer and more intense than for labral repair or debridement, often requiring a more extended period of restricted weight-bearing and a rigorous physical therapy regimen.

Hip Arthroscopy with Femoroacetabular Impingement (FAI) Surgery

In most cases, a hip labral tear is associated with femoroacetabular impingement (FAI), and Dr. Mayo will also address the underlying bone abnormalities during the hip arthroscopy to restore its normal shape and prevent future rubbing and damage. This can involve trimming the excess bone on the femoral head/neck (cam lesion) or acetabulum (pincer lesion), reducing the impingement and providing a better environment for the labral tissue to heal.

Recovery time varies, but patients can typically expect to start walking with crutches immediately after surgery, with a gradual return to normal activities over several weeks. A comprehensive physical therapy program is typically started immediately after surgery to help regain strength and mobility in the hip. Most people can expect to return to light activities or desk work within a few weeks. Full recovery, which includes returning to high-impact sports or

After hip arthroscopy surgery, your hip will likely be swollen and sore. You will need crutches to help you walk for several weeks while your hip heals. You also will be instructed to avoid certain motions such as flexing your hip past 90 degrees, or letting your hip roll to the outside.  You will have some pain after surgery, but you’ll be prescribed pain medication by Dr. Mayo to help manage this discomfort.

Postoperative physical therapy is an important part of recovery and typically includes:

• Early Stage (Weeks 1-6): Initial therapy focuses on reducing pain and swelling, regaining range of motion, and strengthening the muscles around the hip.
• Middle Stage (Weeks 6-12): As healing progresses, therapy includes exercises to improve strength, stability, and endurance, as well as gait training.
• Late Stage (3 months onwards):The final stage of therapy focuses on functional exercises and activity-specific training to prepare you for a return to work, sports, or daily activities.

While hip arthroscopy with labrum repair and FAI correction is generally a safe procedure, potential risks can include:

• Infection: Occurs in a very small percentage of patients. You are given antibiotics during hip arthroscopy to minimize this risk.
• Nerve damage: There’s a very small risk of injury to the nerves around the hip. Dr. Mayo performs this procedure with the latest techniques that limit the chances of this happening.
• Blood clots: Deep vein thrombosis (DVT) or pulmonary embolism (PE) can occur but are rare. You will be given aspirin to take for 30 days to minimize this risk.
• Failure of the labral repair or recurrence of FAI: While the goal of hip arthroscopy surgery is to fully correct the issues, there’s a chance that problems could recur or not fully resolve, requiring further treatment.
• Excess bone formation: In a small number of patients, their body reacts to the hip arthroscopy surgery by forming some excess bone in the soft tissues around the hip. Often these do not cause any problems, but they may cause pain and limit motion which very rarely need a surgery to remove. You will be given a medication after hip arthroscopy surgery to reduce the chance this bone forms.
• Femoral neck fracture: In exceptionally rare instances, the amount of bone removed from the femur deformity could weaken the bone and increase the chance of a fracture.

If it is recommended you have hip arthroscopy and you choose not to undergo surgery, potential risks include:

• Continued pain and mobility issues: Without hip arthroscopy, the hip pain and mobility problems are likely to persist.
• Further joint damage: Over time, untreated FAI and labral tears can lead to further damage to the hip joint, possibly resulting in early-onset arthritis.