Why should I have a Labral Repair?
Labral repair is only indicated where a definite labral tear has been confirmed on imaging and there are symptoms of pain, restricted movement and limitation in activity. Labral repair is usually found in association with femoro-acetabular impingement. Repair of such tears is a complex procedure as it involves repair of damaged soft tissue of the labrum as well as addressing the underlying impingement. This may involve removal of bone from the head / neck of the femur to prevent further impingement
How long does the procedure take?
Labral repair and reconstruction is performed as part of a hip arthroscopic procedure (keyhole surgery). The operation usually takes somewhere between 1 and 2 hours.
What risks are associated with labral repair and reconstruction?
Hip arthroscopy carries risks including:
Infection – this is rare but potentially very serious, less than 1 in 1000 patients develop infection. Further surgical procedures are likely following infection of the joint and an increased risk of arthritis.
There are specific risks including residual discomfort. The outcomes from hip arthroscopy and labral repair, including that 85% of patients have improvement in symptoms, 10% can see little change in symptoms an 5% of patients can have deterioration in symptoms following surgery, usually related to underlying wear and tear arthritic change. Occasionally, the repair of the larbrum can fail requiring further surgery.
There are other risks including retained instruments which can break in the joint during surgery and there are rare reports of damage to nerves, blood vessels or fracture of the bone at the time of surgery. Traction can cause transient numbness in the groin perineum or foot, this usually resolves within a few weeks.
In addition your leg may be swollen and this is completely normal, however if your calf were to become particularly swollen with associated pain, redness and hardness however, this could be a sign of a clot and you would need to contact your GP or Stafford Suite urgently.
You may also experience spasms in the muscles around the hip in the weeks following surgery. These are perfectly normal and your physio would be able to show you how to manage them.
The risks of general anaesthetic will be discussed with you ahead of your surgery by the anaesthetist that will be looking after you during your operation.
How should I look after my surgical wounds?
There will be 3 small cuts on the side of your hip following hip arthroscopy and labral repair. Each small cut will be closed with a single stitch, you will be given dressings to keep the wounds covered in the postoperative period and care should be taken regarding this. Arrangements will be made for you to re-attend clinic at around 2 weeks following surgery and your stitches will be removed then.
How should I manage my pain after surgery?
Hip arthroscopy and labral repair is not usually a very painful operation. Your pain relief will be managed whilst you are in hospital and you will be discharge you should be able to manage adequately with oral pain relief, including paracetamol, codeine and non-steroidal anti-inflammatories.
What rehabilitation should I do after my surgery?
Dependent upon the findings and procedures performed at hip arthroscopy, we use 2 different protocols for rehabilitation, the single and the complex. The single protocol involves crutches for 2 weeks and the complex protocol involves use of crutches for 4-6 weeks following surgery. You should not drive for 2 weeks following hip arthroscopic surgery. Your physiotherapist and Mr Hoad-Reddick’s team will advise you regarding appropriate rehabilitation in the postoperative period. You can download copies of the simple and complex hip arthroscopy protocols here.
How should I use crutches after my surgery?
The physiotherapist will see you both before and after your operation and will train you in the appropriate use of crutches so that you are safe on discharge from hospital.
How long will my recovery from surgery take?
Hip arthroscopy and labral repair recovery takes quite a long time. It is not unusual for it to be impossible to return to normal sports including football and running for between 3 and 4 months following surgery. Full recovery can take between 6 and 9 months following surgery and sometimes up to 1 year.
Labral reconstruction is a well established technique but only available at a few centers in the UK.
In a small number of cases the acetabular labrum shows more extensive damage than anticipated at the time of hip arthroscopy. Following labral resection, some patients may require a further specific procedure in order to reconstruct the labrum. This is also performed using an arthroscopic technique requiring general anaesthetic and an overnight stay. Donated tissue or the patient’s own tendon may be used in order to reconstruct the damaged labrum.
A complex rehabilitation program with intensive physiotherapy follows the surgery and crutches are required for approximately six weeks.
For more information, please call the office 0161 722 0007 or email us at secretary@hrorthopaedics.co.uk