Arthroscopic Labral Reconstruction

Arthroscopy is a minimally invasive surgical technique used in the treatment of sports medicine injuries. It involves the use of a fiber-optic camera, which we place into a joint through a small incision in order to visualize ligaments, cartilage, and soft tissue. Through another small incision, we can then use small instruments to remove or repair broken or damaged tissue.

Arthroscopy of the hip with labral reconstruction is a procedure that may be necessary if you’ve had previous arthroscopic hip surgery in which a large portion or the entire labrum was removed. Reconstruction is also sometimes indicated if the labrum is torn beyond repair.

A patient undergoing this procedure will have their labrum reconstructed with use of an allograft (cadaver tissue) or the patient’s own tissue (commonly iliotibial band is used). The reconstruction of a damaged or incomplete labrum is important to recreate the suction seal function of the labrum in the hip joint. This provides the patient with hip stability and resolves pain commonly associated with a labral tear.

The reconstruction is completed arthroscopically and is minimally invasive. First, the hip socket is debrided (cleaned up) to remove any damaged or inflamed tissue. Once the native labrum is evaluated, the allograft is inserted into the hip and secured to the rim of the hip socket. This is attached using very small pegs that are inserted into the cup. These are made of plastic and will dissolve away over time. There is no metal placed in your hip.

If you also suffer from impingement syndrome in your hip, an osteoplasty (shaving down) of your femoral neck (the ball of the hip) or the rim of your socket (acetabulum) can be done as well.

Postoperative Instructions:

MOVEMENT

  • You can weight-bear as tolerated after surgery; however, it is required that you use crutches for 2 weeks postoperatively to provide you with extra stability and to protect your hip. Do not hyperextend or hyperflex your hip. This will be painful. Only move your hip within a pain-free range of motion. We encourage you start riding a stationary bike the day after surgery for 15-20 minutes with no resistance or incline. This will help prevent stiffness in your hip.

BRACE

  • A hip positioner brace has been provided for your use. Please wear it at night while you sleep for the first week after your surgery. This will keep your feet straight and not allow your leg to turn out.

ICE

  • An ice machine will be provided to you prior to your surgery. This will help decrease swelling and pain after your surgery. Use the ice machine as much as possible when you get home at intervals of 30 minutes on and off. You should keep the ice machine for approximately two weeks. Do not use the ice machine while you are sleeping.

MEDICATIONS

  • An injection of local anesthesia was injected into your hip after the completion of the operation. This medication will wear off in 5 to 6 hours. Therefore, begin taking the pain medication (e.g. Vicodin, Percocet, etc) immediately when you get home. This will prevent you from having severe pain. Take the pain medication every 4 hours until you go to bed.
  • The day after surgery you can take 600 mg of Ibuprofen (Advil/Motrin) every 6 hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking the Ibuprofen, continue taking the pain medication every 4-6 hours as needed.
  • A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.

DRESSING/BANDAGES

  • Your hip dressing is waterproof. You may shower the next day after surgery. Two days after surgery you may remove the entire dressing. Gently wash the wounds with soap and warm water and towel dry. You may then cover the incisions with band-aids until your post op visit.
  • Do not take a bath or submerge your hip in water until your incisions are checked at your first post-op visit.

APPOINTMENT

  • Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.

If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.

Download the postoperative instructions for your procedure (PDF) 

 

Recovery Timeline:

Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one and a half to two hours, and recovery time is one hour. For immediate post-op instructions, download the instruction sheet.

One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Your stitches will be taken out. You will continue icing the surgical area two to three times a day (or more if needed). Continue wearing hinged hip brace. Do not do any stretching exercises for the first month after surgery. Begin taking Naprosyn twice daily for the next month.

Four weeks post-op: Second follow-up visit. Discontinue hip brace. Physical therapy begins to work on strengthening exercises and gentle range of motion.

Eight weeks post-op: Third follow-up visit. Range of motion and strength testing. If additional range of motion or strength training needed, continue physical therapy to work on these. Pain should be mostly resolved at this point.

Twelve weeks post-op: Fourth follow-up visit. Range of motion should be full/normal. You should feel stronger and have very little pain, if any. Near to full recovery is expected at this time.





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