Labral Tears – Repair vs Reconstruction
Dr. Michael Ellman is a sports medicine specialist at Panorama who specializes in hip arthroscopy and repairing labral tears in the hip. He prides himself on his conservative approach to performing arthroscopic labral repairs to address hip pain.
A patient with a torn labrum can typically obtain pain relief through either a repair or a reconstruction of the labrum, an important ring of cartilage inside the hip socket that provides lubrication and stability to the joint.
In a repair, the patient’s own torn labrum tissue is reattached to the hip socket. With a reconstruction, the torn labrum is removed completely and replaced with non-living tissue from a donor, or from another part of the patient’s body.
“The vast majority of hip arthroscopy surgeons, including myself, are routinely performing labral repairs rather than reconstructions for patients with torn labrums,” said Dr. Ellman of Panorama Orthopedics & Spine Center in metro Denver. ”The evidence suggests that a repair gives patients an excellent chance at a full and speedy recovery, and provides them with an opportunity to successfully return to sports. If your own labrum is healthy enough to be reattached, that is typically the best option.”
Dr. Ellman also performs reconstructions when necessary, but only when the labrum tissue is not suitable for repair. “There is a time and a place for reconstruction, there absolutely is, and patients who need it can do very well,” Dr. Ellman said. “But it doesn’t make sense if a person would be better served by retaining their own living tissue. I am able to perform a repair for greater than 95 percent of my patients with labral tears.”
Dr. Ellman said that in addition to being a less extensive and less costly surgery, repairs also might give a patient the best chance of avoiding a future hip replacement.
Repairs have up to a 90 percent success rate, but if a repair fails and the patient still has pain, the back-up option would be a labral reconstruction, he said. Unfortunately, if a patient had a reconstruction for a torn labrum, their native labral tissue has been removed so the back-up option would likely be a hip replacement.
“I treat a large number of young athletes, and that is the last thing I would want for them at an early age,” Dr. Ellman said. “There is a benefit to approaching labral tears conservatively, and that is one of the reasons patients do extremely well in my care.”