Hip Labrum Reconstruction
The labrum of the hip is like a gasket, it helps to seal the ball and socket joint. This keeps the lubricating joint fluid in the hip and helps to prevent “micro-motion”. When the labrum gets torn it can be very painful and can lead to abnormal motion of the hip which wears out the cartilage and leads to arthritis. In most cases, once the labrum is torn of the bone it needs to be repaired back surgically or reconstructed. Reconstructions are more common in revision surgery (2nd or more surgery in the hip) or chronic injuries.
Surgery to reconstruct the labrum with Dr. Petre is done arthroscopically. First, the cause of the labrum tear is addressed by removing any excess bone. Dr. Petre will move your hip in all directions, especially in any sport specific movement to ensure that all impingement has been removed. The torn labrum is then reconstructed using a peice of your IT band as a graft. This graft is harvested from the same leg and converted into a labrum before being implanted. Your body will incorporate it and change it to function as a new labrum over time. The reconstruction graft is held in place with a series of bone anchors that get buried into the pelvis. The anchors have sutures that are then used to repair the labrum back to the bone. The labrum will heal itself to the bone over the next six weeks. Surgery can take 4-6 hours and you may or may not stay in the hospital one night. Surgery does require that patients go to sleep and traction (pulling on the leg) will be needed to provide access to the hip.
Patients recover from labrum repair in phases. Initially (starting immediately after surgery), the focus is on gentle motion. Early gentle motion exercises are the key to preventing scar formation and maintaining a full hip range of motion. A continuous passive motion machine (CPM) may be used in addition to stationary bike and physical therapy exercises. If you work on your feet, do no heavy lifting and can do your job with crutches, you should plan for 4 weeks off of work. If your job requires heavy lifting or a lot of walking, you should plan for up to 3 months off of work. Patients will need to arrange transportation as you may not be able to drive for 2-6 weeks afterwards especially if it is your right leg that needs surgery. The second phase of recovery and rehabilitation focuses on strengthening the hip, pelvis, and spine. The third and final phase focuses on sport specific recovery so that you are ready to play when you are cleared by Dr. Petre. Typically, all three phases of recovery take approximately 4 months.
- How long does surgery take? Anywhere from 3-6 hours depending on what needs to be done surgically
- What kind of anesthesia will I need? This surgery requires general anesthesia and an epidural can be added for pain control after surgery
- How long will I be in the hospital? Patients stay one night after surgery and go home the next morning.
- Is surgery safe? All surgery has risks; however, when compared to all surgery, labral repair operations are very safe.
- Will I need physical therapy? Yes. Physical therapy is a crucial part of getting an excellent outcome.
- How long before I can return to work/school? Low demand, desk jobs and academics that can be done on crutches can usually be done in 3-4 weeks. Heavy lifting, manual labor, or jobs that can’t be done on crutches can be 8-12 weeks.
- How long before I can return to my sports? Usually 4 months.
- How long before i can drive a car? All patients must be off pain medicine before driving. Each patient will be different in terms of their ability to return to driving. It is safe to plan for 4 weeks off of driving, many people can return before that.
- How long will I be on crutches? 3 weeks in no microfracture is done, 8 weeks if a microfracture is needed.
- How long will I need pain medicine? Most patients are off of pain medicine with 5-14 days. Dr. Petre will ask you to see a pain specialist if you are still requiring pain medicine one month out of surgery.
- How long will I need a brace or sling? 3 weeks in a hip brace.