Hip Labral Repair / Reconstruction
Background
The labrum is a ring of cartilage around the rim of the hip socket. It helps stabilize the joint and maintain a seal around the ball of the hip. A torn labrum can cause groin pain, catching, and discomfort with sitting, twisting, or sports.
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Labral tears often occur alongside femoroacetabular impingement (FAI). FAI develops when extra bone on the femoral head and neck (cam impingement), the socket rim (pincer impingement), or both causes the bones to contact each other during hip movement. When surgery is appropriate, treating the labral tear and correcting the impingement are both important parts of the plan.
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Labral repair preserves and reattaches the patient’s own labrum. If the tissue is too damaged or deficient to repair reliably, labral reconstruction uses a tendon graft to recreate the labrum. The final choice depends on the quality of the tissue seen during surgery, as well as the condition of the cartilage and the rest of the joint.
The Surgical Procedure
Hip labral surgery is generally performed arthroscopically, using a camera and specialized instruments inserted through small incisions. Surgery may also address FAI, cartilage damage, or other problems identified inside the joint.
Labral Repair
When the labrum has enough healthy tissue, it is reattached to the rim of the socket using small suture anchors. The goal is to preserve the native labrum and restore its function.
Labral Reconstruction
When a labrum is severely damaged, calcified, deficient, or has failed a prior repair, it may not be possible to repair it effectively. In selected patients, a tendon graft can be secured along the socket rim to reconstruct the labrum and restore its seal. The graft and extent of reconstruction are chosen based on the findings in the hip.
Correcting the Impingement
When cam impingement is present, a femoroplasty reshapes the femoral head and neck to improve clearance during movement. When pincer impingement is present, an acetabuloplasty removes excess bone from the socket rim. One or both may be performed when needed. Any cartilage damage is assessed at the same time and may affect the procedure and recovery plan.
Recovery Timeline
Recovery varies depending on whether the labrum is repaired or reconstructed and whether bone reshaping, cartilage treatment, or other procedures are performed. Your postoperative instructions will reflect the work done during surgery.
Early Recovery (Weeks 1 - 4)
The focus is on protecting the hip, controlling pain, and beginning gentle movement.
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Crutches are commonly used while weight bearing gradually increases.
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Physical therapy begins with protected motion and exercises to restore normal walking.
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Some hip positions and movements are temporarily limited to protect the healing tissues.
Intermediate Recovery (Weeks 4 - 12)
Physical therapy progresses toward a normal walking pattern, improved range of motion, and strength in the hip and core. Low impact exercise is introduced as tolerated.
Late Recovery (Months 3 - 6)
Strength, balance, and movement control continue to improve. Running and more demanding exercise may begin when the hip is ready and the rehabilitation milestones have been met.
Return to Sport (Months 6 - 12 and Beyond)
Sport-specific drills progress toward full activity. Timing depends on the procedure, the demands of the sport, and demonstrated readiness, including strength, hip control, and the ability to perform sport movements without pain. Recovery may take longer when substantial cartilage damage is treated.
What to Expect
Pain Management
We utilize a multimodal approach including a nerve block when appropriate, oral medications, and ice therapy to minimize the postoperative pain and to limit narcotic use. Swelling and discomfort are expected early on, but most patients find their pain very manageable with this comprehensive approach.
Crutches and Walking
You will use crutches after surgery while your hip begins to heal. How much weight you can place on the leg depends on the procedures performed, particularly if cartilage damage is treated. Your specific instructions will be reviewed with you after surgery.
Sitting, Stairs, and Driving
Sitting for long periods may be uncomfortable at first, so change positions regularly. Stairs will become easier as your walking improves. Before returning to driving, consult Dr. Fliegel. You should no longer be taking medication that impairs alertness and must be able to control the vehicle safely. Driving may take longer after surgery on the right hip.