hip labrum tear surgery

I've just been diagnosed with a hip labrum tear following an MRI Authrogram (contrast dye is injected into the hip joint and then an MRI scan is performed).

I'm 32 and was running on average 20-30 miles per week pre-injury, ran the Sheffield half in April and was training for the Liverpool marathon in October (managed to get to 17 miles on my long run before I had to stop due to my injury. I'm now completely inactive; even walking a short distance hurts.

I've not ran at all since the summer due to the pain and have pretty much suffered all year with all sorts of suggestions from physios and my GP as to the cause of my pain including ITBS, unstable pelvis and bursitis!

Finally after enduring physio which seemed to do more harm than good, I was referred by my GP to a consultant who, after a few basic tests, immediately said I had a hip labrum tear (he is a runner and also had the injury in both hips!). The MRI has confirmed his diagnosis and I have been told I will need surgery to repair the tear.

There is only one consultant available on the NHS based at Leicester Hospital who apparently can do the hip arthroscopy procedure and my consultant has recommended I am referred to Leicester but it's all down to funding and whether or not my trust will agree.

My other alternative is open hip surgery locally which I understand has a much greater recovery time with more complications.

Has anyone had this surgery (either arthroscopically or open surgery?)

What is recovery like? When can I expect to run again?

Comments

  • Check with the paris thread. NGUG( never give up girl) has had this last year and is back running after surgery.Might be no harm to post there as well in case non injured people dont check this board

  • One of the best hip surgeons in the UK for arthroscopic hip surgery is Mr Richard Villar (based in Cambridge).  His post-op protocol has people back running at 4 months.  Open surgery takes much longer as they have to peel the muscle back off the bone so it takes much longer to heal (9-12 months for return to running)
  • Thanks for that, is he an NHS consultant? Really hoping I don't have to go down the open surgery route!
  • Just had bilateral hip arthroscopy (both hips) one had the labrum coming away and extensive cartilage damage to clean up, one had the start of this condition and a cyst that had formed as a result .Both had FAI and needed bone bumps smoothing. My surgeon said he wished he could have sorted the worse hip earlier as there has been quite a bit of damage as a result of the tear and coming away of the labrum, this may always cause me some problems even with repair.

    But quite simply I only had pain for 4 months and it wasn't that bad. (it takes that long to get referred and be checked out and I was quick off the mark). I could still get running quite easily and had pay back pain afterwards. Infact pain is too strong a word, it was more discomfort which a few nurofens would sort out. I felt I was being a bit over self indulgent in having the treatment as I could still run half maras etc. and if I stopped running I had no symptons after a few days.But something made me do it. 

    I'm glad I did as the damage was getting rapidly worse and was on the brink of being very painful and perhaps irrecoverable. They only know for sure whats going on when they get inside and have a look. Most scans are pretty inconclusive and only give a guide.

    I am grateful to a brilliant physio who knew what I had straight away and I didn't waste months and months of physio and stretching and running whilst my hips continued to be destroyed. This seems to be most peoples experience before diagnosis. I did do the Wilmslow Half and numerous parkruns in the lead up to my op which probably were not advisable but I could do with only minimal discomfort.

    The procedure is quite a big one. I was out for 4 hours under general. But afterwards I have been fine. From day 1 walking about, no pain, some stiffness, on an exercise bike on day 2, no painkillers needed. I want to get back to running 40miles per week. I know my surgeon will convince me to cut this down and he is right from no other reason that it will wear again even if a perfect hip. I will diversify into triathlons I think and cut running back.

    the rehab sounds long, frustrating and daunting. This nearly made me decide not to have it done. But time flies and with focus you can make it a real challenge and something to achieve.

    feel free to ask me anything about it richardhall181@yahoo.co.uk my wife is fed up of hearing me talk about it!

     

  • Hi Richard

    So you are glad you had it done...I have just had a steriod injection for a labrel tear, waiting to see surgeon in 2 weeks to see what they are going to do...first off I was told that not everyone gets fixed with the surgery so to be cautious about it...any advise.

     

    Think my husband is fed up of hearing about it too...but hey it affects daily life does't itimage

  • On day 2 I asked my surgeon when I would be able to run again and he said he didn't know whether I ever would as eveyone reacts differently to the surgery. This frightened the hell out of me but he was being honest and din't want to raise expectations I guess.

    However I have had very few hip problems since and do a lot of running and cycling (its now 6 months since surgery and I was running within 8 weeks). I have had some strange tweaking of hip flexors and calf muscles which I have had to work hard to manage (stretching like mad etc)

    tips

    your labral tear will always be there and a steriod will not solve the problem that your hip will no doubt wear away faster as a result. So you need to weigh up whether you would like to run for many more years. If you can cope with cycling and less running you might be right to see how the steriod helps and stick with it

    The other consideration is what caused the tear. If it was over exertion and its stabilised then it might be ok. if its an impingment (boney bit causing damage) then you will only do the same again or it may worsen. If you have a scan and your good hip also has impingment....consider having both done

    Search the web and you get all the horror stories. I did this in making my decison and had to keep telling myself that people post up stories when things go wrong....not normally a good news story. (so ignore)

    If you decide to have it done I am convinced that an 8 week programme of rigoros hip/core strengthening pre op was the most important thing I ever did. I went mad at this and have stronger flexors and core then I ever have had as a result.

    Post op it is important to rest for 8 weeks (swimming etc is ok). I kind of ignored this as I felt so good. I paid a little at 6 weeks when my muscles started to do wierd things. I would follow protocol rigidly if I had time again as they were always right and sorted it out with physio.

    Hope that helps

     

     

     

     

     

     

  • Thank you all for posting some more good news stories on hip issues. 

    I was diagnosed with labral tear and impingement on the left hip 4 years ago.  At the time I also had a Gilmore's groin issue and so had surgery on that rather than the hip and after 6 months of core work was able to get back running and not have the more intrusive hip surgery.  Have to say that everything was great and have been running 100 milers, doing Ironmans and the like.  However, the tear and impingement obviously do not repair themselves and so when I started to feel pain again a few weeks ago I started to fear the worst.  Went to see a sports doc with lots of experience in hips and following an MRI she is referring me to a consultant but thinks I will certainly need the labral tear repaired and the impingement shaved.

    I suppose I was expecting this but having started to search the net for others experiences I was horrified by the number of bad news stories.  My doc told me to expect up to 4/5 months without running (conservative), which I can live with as I like to bike as well, and that ideally i should not be looking to run marathon distances and up in the first 12 months.  I could also deal with this as long as I know I can get back to the ultra running at some point.

    What are people's experiences of getting back to the longer distance racing following FAI and tear surgery?  Am I crazy to be hoping that I can get back to running those distances.

  • everyone is different is the clarity you will get from medics and they are right. but I wouldnt mind betting that given your core strength you will be back running 5k 10k etc within 10 weeks. Cycling sooner. I have found though even after 6 months that my hip muscles which were invaded in the procedure are still prone to tightening and causing knock on issues. Cycling actually complements running and vice versa in relaxing them though. Remember the bone takes a few months to heal after shaving so essentially it is raw and sore and the quicker you come back to exercise the longer this process will take. I know what this pain is and can live with a bit of this soreness as I was keen to get back. I did half marathon in 90mins at 4 months and run 20miles in one go at around 4 months. I don't do marathons and never have but wouldn't think a problem. Youre not crazy but don't feel disappointed if it takes a bit longer than you hope for. Also remember that damage has been done and this will only be partially repaired....it will always be an area that could worsen and I wouldn't mind betting that medics say try and cut down on mileage and do more cycling.

  • I've just got these findings from an MRI and am terrified of surgery:

    Bilateral mild sprains right greater than left foveolar attachment ligamentation teres.
    Small to moderate sized area of calcific gluteus medius tendinosis measuring 7 x 6 x 5 mm partially ruptured into the sub gluteus maximum bursa. Associated mild sub gluteus medius bursitis.
    Mild gluteus minimus insertinoal tendinosis.
    Mild thickening of the adjacent tensor fascia lata.
    Minimal left sub gluteus maximum bursitis with milf gluteus minimus minimal gluteus medius insertinal tendinosis.
    Minimal right greater left hamstrings origin tendinosis involving semimebranosus and adductor magnus tendon origin in particular.
    Minimal degeneration symphysis pubis.
    Minimal degeneration both sacrooilliac joints.
    Mild to moderate lumbar spondylosis jooints.
    Mild to moderate lumbar spondylosis affecting L5 S1 facet joints greater than remaining. lower 2 lumbar discs.
    Tensor fascia lata origins appear normal.
    Old tendon tear of the mid left rectus femoris.
    Piriformis muscles appear relativel;y symmetrrical.
    Illolumbar ligaments appear normal.
    Imaged pelvis viscera appear within normal limits.
    No evidnece of a hernia of pre hernia.

    Conclusion:
    Bilateral fermoral acetabular impingement
    CAM type femoral heads with anterior lateral femoral head neck junction bumps, lateral acetebular over coverage
    Bilateral mild degeneration right greater left anterior lateral horizontal greater than posterior lateral vertical portion of both hip jopiints.
    Small to moderate partial tear right anterior lateral, superior anterior acetebular labrum.
    Degeneraive attenuation fraying and small tear left anterior lateral acetebular labrum.
    Subtle cartilage flap 3 mm anterior lateral right acetabulum.

    Moderate calcific tendinosis right g;luteus medius lateral tendon insertion. Associated mild sub gl;uteus maximum bursititis, minimal sub gluteus bursitis and mild gluteus minimus uisertinal tnedisnosis.

    Mild left gluteus minimus insertional tendinosis with minimal sub gluteus maximus bursitis minimal gluteus medius tendinosis.


    I've just had three 5min sessions of shockwaves on the right hip and consultant suggested I wait 3 months before assessing the need for more, but said meanwhile we can do 3 sessions on left hip. Not sure about results yet but sometimes think the pain is slightly less.

    I'm not overly active (or overweight) but always had hip and lower back pain as far as I can remember - for years, I had an MRI in 2012 which showed nothing,

    Since 2012 I have done some yoga and gym which has made my muscles feel great but may have damaged my hips - is that possible?

    I'm anxious about having the dye injection, and instead looking at the possibility of a 3T scan.
    Has anyone here had a 3T scan and is it highly accurate ?

    I'm in pain constantly and can't sleep and if I do sleep I'm awake in pain the minute I turn.
    How do you teach yourself to lie on your back and not turn in your sleep? Isn't this a problem post op for people?

    I'm absolutely terrified of surgery.

    Any thoughts on the way forward would be appreciated. Would I get away with no surgery?
    What are the dos and don'ts re bending, stretching, turning etc ?
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