Arthroscopic Labrum Reconstruction
The labrum is strong fibrocartilaginous tissue that forms a rim at the socket of the hip joint. It acts as a shock absorber, lubricates the joint and distributes pressure equally. It deepens the socket increasing the stability of the joint and limiting movements of the head of the femur. Trauma, repetitive movements or structural abnormalities can cause damage to the labrum. Reconstruction of the labrum is performed if it is damaged beyond repair and may be performed through arthroscopic surgery, a minimally invasive procedure performed through a few small incisions.
The labrum is reconstructed either with tissue from a cadaver (allograft) or with tissue from the patient’s own body (autograft). The iliotibial band or hamstring is commonly used for this purpose. Labral reconstruction can relieve pain associated with labral injury and improves the stability of the hip joint by restoring the suction seal function of the labrum.
During the procedure a slender illuminated tube with a camera called an arthroscope is inserted through a small incision and small surgical instruments are inserted through one or more similar incisions. Magnified images from the camera are relayed to a monitor which your surgeon uses to guide the instruments. Any damaged or inflamed tissue is first debrided from the hip joint. The labrum is then inspected and the graft tissue is placed and secured in position with the help of pegs that slowly dissolve over time. The entire procedure takes about 2 hours.
To control pain, your doctor will administer a local anesthetic injection at the end of the procedure. You will also receive a prescription for pain medications. Application of ice is recommended for pain and swelling. Following the procedure, you are advised to use crutches for 2 weeks for safety and stability, although weight bearing is allowed as tolerated. You should avoid hyperextending or hyperflexing the hip or any movement that causes hip pain. Mild range of motion exercises such as stationary bike riding is recommended from the day following surgery to prevent stiffness. A hip brace is recommended for use at night to hold the hip in a safe position. You should follow up with your doctor within a week and will then begin a physical therapy program to improve strength and flexibility of the hip joint. Full recovery usually takes about 12 weeks.
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