Surgery for a hip labrum tear has become incredibly common in the last 5 years. It seems like every patient with a hip labral tear gets arthroscopic surgery to “repair” the tear or to cut out the torn pieces. The hip labrum is the lip on the socket into which the ball of the femur fits and helps to stabilize the joint. However, what does the research say about hip surgery labral tear recovery? Does this surgery work? A new study out of Mayo clinic suggests the benefits of the surgery are very over rated.
The study authors operated on 59 hips in 57 patients. Of note, a staggering 45% of the patients had poor results by an average of five years after the surgery! In particular, patients who had “chondroplasty” fared worse than other patients. What’s that? This is when the surgeon debrides the cartilage (“cleans it up”). Why would this make things worse? Cutting out cartilage reduces the amount of cushion in the joint. Of the 45%, 25% ended up needing a second surgery and 20% reported they had an abnormal hip after the procedure.
Not wanting to throw a huge new trend in orthopedics under the bus, the authors state that patients who had “untreated” hip impingement did worse (the implication being that this needed to be treated, but wasn’t). However, I reported on another recent study that showed that this “impingement” was really just a reaction of the joint to protect the cartilage, so why would we want to remove these bone spurs causing “impingement” if they’re protecting the hip joint?
The upshot? According to this Mayo Clinic study, hip arthroscopy to treat a labral tear has some pretty bad outcomes. This is generally consistent with our experience. For example, check out our case series of patients with chronic hip arthroscopy portal pain. In addition, other studies have shown no relationship between a hip labral tear as seen on MRI and pain. So, why are we operating on all of these hips again?