Arthroscopic Labral Repair with Osteoplasty of Femoral Neck and Acetabulum
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.

Hip arthroscopy with labral repair is performed on patients who have torn their labrum as a result of impingement syndrome in the hip (also known as femoroacetabular impingement, or FAI), or as a result of trauma where there is an impact on the hip joint (for example, from a car accident). Using small instruments, the torn part of the labrum can be repaired and reattached to the rim of the acetabulum, thus recreating the suction seal of the hip joint.

If the labral tear is a result of FAI, then an osteoplasty of the femoral neck, acetabular rim, or both may be necessary. An osteoplasty is the surgical alteration or reshaping of bone. This is performed to ensure that the repaired labrum is protected and tearing of the labrum does not recur.

The labrum is repaired using strong suture that is wrapped around the sagging or torn part of the labrum. By using surgical anchors, essentially small plastic pegs that hold the suture in place, the labrum can be resecured to its appropriate position on the rim of the acetabulum. These pegs do not contain metal and will break down and dissolve away over time. The suture will keep the labrum fixed to the rim of the acetabulum, and will help the labrum scar into position. It is common to use two or three of these anchors in a hip arthroscopy with labral repair.

The osteoplasty portion of this procedure is performed using small shaving instruments that shave down the excess bone on the acetabular rim and/or the femoral neck, allowing the surgeon to contour the bone so that the labrum is no longer pinched with movement of the hip.

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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