About The Hip Surgery
Repairing the Labrum (Labral Tear)
The Labrum is a fibro-cartilaginous ring that runs along the rim of the hip socket (acetabulum). About 1 cm wide it blends with the articular cartilage that makes the 'horseshoe' shaped weight-bearing portion of the hip socket. It can vary widely between patients, often narrow with a pincer deformity or friable in those with degenerative disease. It has an important role in stability and fluid lubrication of the joint. A rich supply of nerve fibres explains why even a minor injury can cause patients pain.
The labrum can tear after a single injury such as a fall or as a result of repetitive injury such as FAI. It is a common cause of hip pain felt in the groin, back, knee or lateral (side) aspect of the hip.
It has been reported that 66% of patients with mechanical symptoms reveal a tear following MRA. Mechanical symptoms include clicking, catching, popping or feeling of giving way. The labrum tears with the normal degeneration of the joint from wear. As a result many tears are associated with osteoarthritis and are not suitable for arthroscopic repair.
There is good evidence to support repair of the labrum in the case of a tear. This can be a challenging procedure and requires surgical expertise and experience. You should ask your surgeon how many labral repairs they perform. A sound repair will preserve the integrity and function of the hip joint. It is only in a small percentage of cases eg. those with marked degenerative changes or a very thin labrum that an alternative labral debridement should be performed.
In cases of Pincer Impingement your surgeon will perform 'rim trimming' or osteochondroplasy of the hip socket. This involves separating the labrum from the bone rim, using a spinning burr to remove bone from the rim then refixation of the labrum to the bone rim with anchor sutures.