Is Hip Labral Tear Surgery The Right Solution For You?

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.

A hip labral tear can significantly affect mobility and quality of life, often causing persistent discomfort and limiting daily activities. For those diagnosed with a hip labral tear, determining whether surgery is the most effective treatment option can be challenging.

The following article explores key questions about hip labral tears. It provides insights into surgical and non-surgical treatment approaches, offering valuable information to support an informed decision-making process.

Understanding Hip Labral Tear Surgery

Hip labral tear surgery is a procedure that addresses damage to the labrum, a fibrocartilage structure lining the socket of the hip joint. The labrum stabilizes the hip joint and cushions its movement.

When torn, it may lead to pain, stiffness, and a restricted range of motion. Depending on the extent of the injury and the patient’s specific needs, surgical approaches can include repairing, reconstructing, or removing the damaged portion of the labrum.

Different Types Of Hip Labral Tear Surgery

Hip labral tear surgeries are customized based on the severity of the tear and the patient’s needs. These procedures are typically classified into two main categories: arthroscopic and open surgery.

Each approach involves unique techniques, recovery timelines, and expected outcomes. Below is an overview of what patients may experience during these procedures and throughout their recovery journey.

Arthroscopic Hip Surgery

Arthroscopic hip surgery is a procedure designed to minimize invasiveness, performed through small incisions using a camera and specialized instruments. The surgeon evaluates the labrum during the procedure and may remove damaged tissue or repair the tear. This approach is associated with reduced post-operative pain, shorter recovery times, and minimal scarring.

Patients typically resume light activities within six to eight weeks, with full recovery generally taking three to six months, depending on the individual’s rehabilitation progress.

Open Hip Surgery

Open hip surgery is a more invasive procedure, typically reserved for severe or complex labral tears that cannot be effectively treated with arthroscopic techniques. This approach requires a larger incision, providing the surgeon with direct access to the hip joint for repairs or reconstruction.

While open surgery allows for comprehensive treatment of complex cases, it generally involves a longer recovery period. Depending on the extent of the procedure and the rehabilitation process, patients can expect recovery timelines of six to 12 months.

When Hip Labral Tear Surgery Is Recommended

Hip labral tear surgery is typically recommended when conservative treatments such as physical therapy, anti-inflammatory medications, and activity modification fail to provide adequate relief. Surgery is often advised in cases where the labral tear significantly impacts joint function or poses a risk of long-term complications if left untreated.

Limitations Of Conservative Treatments

Conservative treatments are often the initial approach for managing a hip labral tear, aiming to reduce symptoms and enhance joint function without surgery. While these methods may effectively alleviate mild symptoms or provide temporary relief, they typically do not address the underlying structural damage, particularly in more severe cases.

Recognizing these limitations is essential for setting realistic expectations and making informed decisions about further interventions.

• Physical Therapy: Exercises focused on hip and trunk stabilization can help reduce pain and improve function (1). However, they do not address structural abnormalities or repair damaged tissue.
• Cortisone Injections: While cortisone injections may temporarily reduce inflammation, studies indicate they can accelerate joint damage, harm cartilage (2), and offer only limited relief (3) for hip labral tears.

Hip Labral Tear

Before discussing the success rates of hip labral tear surgery, it’s essential to understand the anatomy and function of the hip labrum.

The hip joint is a deep ball-and-socket joint. The term “labrum” originates from the Latin word meaning “lip,” aptly describing the labrum as the lip-like rim around the socket of the hip joint.

The labrum is a fibrocartilaginous rim—composed of tough, fibrous tissue. Unlike the labrum in the shallower shoulder joint, which primarily provides stability, the labrum in the deeper hip socket contributes less to joint stability.

Hip labral tears can result from wear and tear or trauma (4). Although these tears are often visible on MRI scans, their significance should be approached cautiously. Research has shown that many individuals without hip pain have labral tears (5-7).

For instance, a 2012 study found that 69% of individuals without hip pain had labral tears visible on imaging. Therefore, if you experience hip pain and an MRI reveals a labral tear, linking the tear as the primary source of discomfort requires careful consideration.

If you have an MRI CD or link and wish to understand your imaging further, consider watching the video below.

Femoroacetabular Impingement (FAI)

FAI is the most common reason for hips undergoing arthroscopic surgery. This condition involves the development of bone spurs on either the socket (pincer type) or the ball of the joint (cam type). A bone spur is an area where the bone has grown larger, but it is not always a direct cause of pain.

For a visual explanation of how the pincer type develops and insights into non-surgical treatment options, consider watching the video below:

It’s important to approach the relationship between bone spurs and pain cautiously. For instance, 2013 research indicates that the pincer type of FAI may protect the joint from further arthritic breakdown rather than harm it (8). In addition, a 2011 study found that over 90% of healthy young adults without hip pain had one or more hip MRI findings consistent with FAI (9).

• Hip Osteoarthritis – Hip osteoarthritis occurs when the cartilage in the hip joint gradually wears down, leading to pain, stiffness, and reduced range of motion. Symptoms may worsen with movement or weight-bearing activities, potentially affecting mobility and daily function. Read More About Hip Osteoarthritis.
• Hip Tendon Tears – Hip tendon tears occur when the tendons around the hip joint partially or fully rupture due to injury or degeneration. This may cause pain, weakness, and reduced mobility, often worsening with movement or prolonged activity. Read More About Hip Tendon Tears.
• Hip Osteonecrosis – Hip osteonecrosis occurs when reduced blood flow to the femoral head leads to bone tissue death, potentially causing pain, stiffness, and joint instability. Symptoms may worsen over time, affecting mobility and increasing the risk of hip joint collapse. Read More About Hip Osteonecrosis.

Surgical Techniques For Hip Labral Tear Treatment

Various surgical techniques are available to treat hip labral tears, with the choice of procedure tailored to the extent of the damage and the patient’s specific needs. These procedures are typically performed arthroscopically, using small incisions and specialized tools to minimize invasiveness. Below are the common surgical approaches and what they aim to achieve:

• Debridement: This technique removes damaged or frayed sections of the labrum to reduce pain and improve joint function. It does not involve repairing the tissue but can effectively alleviate symptoms.
• Repair: In this procedure, the torn labrum is stitched back together to restore its structure and functionality, thereby stabilizing the hip joint.
• Reconstruction: For severely damaged or irreparable labral tissue, this approach uses a graft to replace the labrum, providing cushioning and support for the hip joint.

Pros And Cons Of Hip Surgery

Hip surgery for a labral tear can provide substantial relief and enhance mobility; however, balancing the potential benefits with the associated risks and limitations is essential. Each patient’s condition is unique, and the decision to proceed with surgery should be based on a thorough evaluation of individual needs, lifestyle, and medical history.

Consulting with a physician specializing in hip conditions is critical to understanding the full range of treatment options and determining whether surgery is the most suitable path.

Below are key advantages and potential drawbacks when evaluating hip surgery for a labral tear.

Pros Of Hip Surgery

• Pain Relief: Surgery may help address the underlying source of pain and could provide long-term symptom improvement in some patients.
• Improved Mobility: Restoring the labrum’s function enhances joint stability and range of motion, improving overall mobility.
• Potential Prevention of Further Hip Damage: Early surgical intervention may help reduce the risk of developing arthritis or experiencing further joint degeneration over time.

Cons Of Hip Surgery

• Complex Procedure: Hip surgery involves advanced techniques and often requires an extended recovery period, including months of rehabilitation.
• Risk of Surgical Complications: Potential risks include infection, blood clots, or nerve damage. While these risks are generally low with experienced surgeons, they cannot be entirely eliminated.
• Variable Outcomes: Some patients may experience incomplete pain relief or limited improvements in joint function following surgery.
• Limited Eligibility for Certain Patients: Conditions such as advanced arthritis or poor overall health may reduce the viability of surgery as a treatment option.
• Increased rates of conversion to hip replacement

What Is The Hip Labral Tear Surgery Success Rate?

In one of the largest high-level studies to date comparing hip arthroscopy to physical therapy, researchers found there was no significant difference between the outcomes of the two groups (10), indicating that surgery did not outperform physical therapy. In another study, patients with FAI reported better surgery outcomes than physical therapy alone.

However, one study revealed that while patients who underwent surgery experienced earlier pain improvements, they faced worse residual hip pain and function in the long term (11). Additionally, outcomes for hip surgery in cases of labral tears or FAI were worse (12) in patients with arthritis.

To summarize, the current research on hip labral tear surgery success rates does not consistently demonstrate that surgery is superior to physical therapy. Notably, the gold standard for research on this procedure would be a randomized controlled trial comparing surgery to a sham procedure, which has yet to be conducted.

The takeaway? There is insufficient solid evidence to support a consistently high success rate for hip labral tear surgery. Further research is needed to bring more clarity to this topic.

Explore Non-Surgical Options For Managing A Hip Labral Tear

For individuals seeking alternatives to hip labral tear surgery, physicians in the licensed Regenexx network offer interventional orthobiologic procedures designed to support joint function and mobility. These non-surgical approaches focus on addressing joint health while minimizing recovery time compared to traditional surgical interventions.

Procedures using Regenexx lab processes, including bone marrow concentrate (BMC) containing the patient’s own stem cells and highly concentrated platelet-rich plasma (PRP), are customized to each patient’s specific condition. These personalized treatments aim to help manage symptoms and support long-term joint function.

Consult with a physician in the licensed Regenexx network to explore whether these procedures may offer a non-surgical option for managing hip labral tear symptoms.

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.