This article describes the factors to consider when thinking about surgical treatment for a hip labral tear.
The Hip Labrum
The hip labrum is a ring of cartilage that surrounds the socket of the ball-and-socket hip joint. Unlike other ball and socket joints, such as the shoulder, the hip has a very deep and stable socket.
The hip labrum helps to deepen the socket, while also being flexible to allow for some movement.
The hip labrum, like other types of cartilage, lacks a good blood supply and therefore does not have a strong capacity to heal after damage.
Hip Labrum Tears
Hip labral tears come in a variety of shapes, sizes, and types, and the treatment can differ significantly.
Most importantly, labral tears are often seen in the setting of other damage to the hip joint including arthritis and bone spurs. A labral tear in the setting of arthritis of the hip is nothing like a labral tear as an isolated injury.
But labral tears are very common, and they don’t usually cause symptoms. Often, labral tears do not need treatment. In one study, a labral tear was detected in 41 to 43% of asymptomatic hips. Another study found that over 90% of patients age 50 and older had some degree of hip labral tear discovered on MRI.
Hip Arthroscopy
Arthroscopic hip surgery is an outpatient surgery that is often performed under general anesthesia. During the procedure, a surgeon places a small camera with an attached light source into the hip joint and places the surgical instruments through another small incision.
Techniques used during surgery may include:
Repair of the damaged cartilageTrimming out the torn portionReconstructing the labrum
The decision of how to address the tear usually depends on factors including the tear type and location.
Arthroscopic hip surgery has potential risks:
InfectionPersistent painNerve or blood vessel injury
When considering any surgical treatment, it is important to weigh the risks and the benefits of surgery.
Results of Surgical Treatment
A number of studies have reported good short-term results following arthroscopic hip surgery. Most of these studies find that people who undergo hip arthroscopy have good pain relief in the months and years to follow surgical treatment.
Especially when there are no signs of arthritis, these results tend to hold up well over time, and people are satisfied with their treatment.
Only a few studies have compared surgical treatment to nonsurgical treatment.
One study of about 100 military recruits who had hip labral tears randomly assigned them to either get surgery or nonsurgical treatment. Two years after treatment was completed, there was no significant difference between the groups of individuals treated surgically versus those treated nonsurgically.
That is not to say that everyone got better, it just means that an approximately equal number of patients got better with nonsurgical treatment as with surgical treatment. However, 70% of the patients who didn’t have surgery ended up undergoing surgery later.
Labral Tears After Age 40
There has been controversy regarding the treatment of patients over the age of 40 who have labral tears.
Studies have shown that people over the age of 40 have a higher rate of progressive arthritis of the hip joint, and the labral tear is likely an early sign of arthritis in the hip. Almost 20% of these patients ultimately end up having hip replacement surgery within a year and a half of undergoing arthroscopic hip surgery.
A Word From Verywell
Arthroscopic hip surgery undoubtedly plays an important role in the treatment of hip labral injuries. That said, many patients can find equally effective treatment with nonsurgical treatment. In almost all scenarios, nonsurgical treatment should be attempted before considering arthroscopic surgery.
Studies have shown that when nonsurgical and surgical treatment are compared, the results are not too different between these groups; both treatments tend to lead to an improvement in symptoms. There are situations when nonsurgical treatments are not effective, and surgery can be considered.
The ideal candidate for surgical treatment is under the age of 40 years old and does not have signs of arthritis in their hip joint.
Surgery is not typically recommended for people ages 40 and up. This is because a hip labrum tear is often an early sign of arthritis. If you have osteoarthritis, a hip replacement may be needed in the future.
In addition, other treatments, including physical therapy, may be equally as effective as surgery for a minor tear.
On average, it takes about six months to fully recover after hip labral tear surgery. Some people recover in as little as three months, while others take longer to heal. As long as there aren’t any complications or other problems with the hip joint, you should be fully recovered within nine months.
Other things to watch out for:
Avoid sitting on low, soft surfaces as they may be difficult to get up from. Don’t sit cross-legged or with your ankle resting on your knee. Do not lift the leg straight up or pivot over the leg that was operated on.
Once you start physical therapy, it will still be a while until you are able to exercise independently. You will need to avoid high-impact activities like jumping or running for at least 12 weeks—and not until your physical therapist or surgeon approves it.
