Hip labrum surgery is a common procedure, and it typically is done for a labrum tear and hip impingement. It’s easy to assume that because a surgery is so common, there must be plenty of research backing it, so it must be the right solution for you. Unfortunately, however, with hip labrum surgery, supporting research is lacking. Yet we do have quite a few studies that seem to point in the opposite direction, concluding what you’re getting with hip labrum surgery means this surgery may not always be the best plan.
To understand what you’re getting with hip labrum surgery, and what you’re not, it’s first important to understand the complexity of the hip joint and what causes hip labrum tears.
Defining the Hip Joint and Labrum
The hip is a complex ball-and-socket joint (the only other ball-and-socket joint in the body is the shoulder). This design allows for a full rotational range of motion, something other joints, such as the knee or elbow, aren’t capable of. The top of the femur bone (upper leg bone), the head, creates the ball of the hip, while the socket of the hip joint is a shallow cup-like indentation (the acetabulum) in the pelvic bone. The fibrous labrum is affixed around the rim of the socket, and it’s job is to keep the ball firmly and securely seated within the socket as well as add stability.
Bone spurs can grow on the hip joint, either on the ball or on the socket, and when this happens, it can create a hip impingement (the medical term is femoroacetabular impingement). When labrum tears are found on MRI in the presence of bone spurs, surgeons typically associate the two, and the result is often a reshaping surgery in which the bone spurs are removed and the labrum tears are cut out or repaired.
The problem is, labrum tears bone spurs typically develop to stabilize and protect the joint, and labrum tears of often just a normal part of wear and tear that occurs with aging. Let’s learn more.
The Reality of What You’re Getting with Hip Labrum Surgery
It’s important to understand what you’re getting with hip labrum surgery, and what you’re not.
Poorer Results if You Have Hip Arthritis…and Worsening Arthritis
If you also have hip arthritis (even very mild arthritis), research has shown that you are likely to have poorer results with hip labrum surgery. In addition, out of every 10 patients who did have hip arthritis in this study, 6 experienced worsening arthritis after surgery.
Maybe the most disturbing thing you might be getting with hip labrum surgery is an unnecessary surgery. Why? As mentioned earlier, just because your MRI shows some tears in your hip labrum, this doesn’t mean this is the cause of your pain as these tears occur with the wear and tear of aging. In other words, MRI may show labrum tears whether you have hip pain or not. And if you do have hip pain, it can be due to a problem in the low back (this link talks about the knee and the back, but the association is the same for the hip), so an examination must exhaust all avenues before diagnosing the hip pain.
Hip Labrum Surgery Results No Better than No Surgery or PT
Surgery to remove bone spurs on the hip joint has been shown to be no better really than no surgery. In fact, removing bone spurs may be bad for the hip joint as the spur may not actually be causing damage but may, in fact, be forming to protect the hip from arthritis.
Physical therapy (PT) has also been shown to help with hip impingement and is certainly worth exploring before pulling the trigger on an invasive surgery. Interestingly, something as simple as how you tilt your pelvis may impact hip impingement (forward tilting may cause more impingement, while backward tilting may lessen impingement).
We alluded to instability earlier. Bone spurs often grow to provide stability, so cutting them off may create instability in the hip joint. Instability can lead to many problems, such as arthritis, dislocations, and so on.
Just because a surgery is common, this doesn’t mean it’s the right solution, and surgery for hip labrum tear and impingement is no exception. Surgeons don’t often know what they don’t know—only the status quo they’ve learned—so it’s imperative that you do your own research before deciding on a hip labrum surgery.
If you want to learn more about the reality of what you’re getting with hip labrum surgery, and what you’re not, watch Dr. Centeno’s video below: