Hip Labral Tears: Symptoms, Treatment Options, and Recovery

Issues related to hip labral tears?

Symptoms and Medical Consultation Process: Last July, I underwent a lateral hip abduction procedure and felt some discomfort.
The next day, I woke up with tightness and soreness around my left hip, along with a squeezing sensation when lifting my leg.
Over the following week, I developed additional symptoms including lower back pain on the left side, soreness near the left sacroiliac region, and numbness in my left leg.
From late July to November, I received physical therapy (manual therapy and exercise therapy), which reduced discomfort in my hip but increased discomfort in my lower back and buttocks.
The symptoms did not fully improve.
Subsequently, the physical therapist recommended that I visit a rehabilitation specialist for ultrasound-guided prolotherapy.
However, the doctor mistakenly diagnosed my hip discomfort as being caused by lumbar issues and only administered treatment to my lower back and buttocks, which did not resolve the problem.
I returned for physical therapy twice more, but activities such as running, jumping, deadlifting, and long car rides continued to cause discomfort in my hip, lower back, and buttocks.
Consequently, I completely stopped exercising.
While the discomfort level decreased, I still occasionally experience mild soreness (not pain).
Although the discomfort is less severe than at the beginning, it persists intermittently.
Sometimes, when I rush and jog a short distance, the symptoms reappear.
Now, a year and a half later, I visited another rehabilitation clinic at the end of October this year, where they suggested a referral to Chang Gung Memorial Hospital for testing for ankylosing spondylitis (AS).
After undergoing MRI scans of my left hip and sacroiliac joint, it was confirmed that I have the AS gene, but my inflammatory markers were not significantly elevated.
The rheumatologist recommended starting medication for observation.
The orthopedic doctor at Chang Gung interpreted the MRI and concluded: 1.
My condition is a labral tear of the hip joint, which requires arthroscopic surgery for complete resolution.
If it does not significantly affect my daily life, I can choose to manage it conservatively through physical therapy or prolotherapy to alleviate symptoms.
2.
However, physical therapy and prolotherapy can only reduce inflammation but will not cure the condition.
He believes that since I am young, I should consider surgery for a quicker recovery, as neglecting it may lead to early joint degeneration.
3.
After surgery, I would use crutches for the first two weeks (some people may not need them after a few days), can use a squat toilet after six weeks, and can resume exercise after three months.

However, I have several concerns that prevent me from making an immediate decision and would like to know: 1.
What is the likelihood of developing degenerative arthritis as a complication of arthroscopic surgery? What is the risk of avascular necrosis? 2.
The last doctor mentioned that my current condition, although mild (just soreness, no pain), could lead to early joint degeneration over time.
Is this referring to degenerative arthritis? If so, how does the likelihood of this occurring compare to the risk of degenerative arthritis as a complication of arthroscopic surgery? 3.
Some individuals with mild discomfort choose physical therapy or prolotherapy to manage their condition.
How long can one coexist with mild symptoms without engaging in vigorous exercise (walking, using a stationary bike, short walks)? If I maintain my usual activities at a moderate pace, is there a high risk of worsening symptoms later? Is it possible to maintain this condition for several decades without deterioration? 4.
Currently, I only experience soreness without pain.
If I wait until pain develops to seek treatment, will the treatment options remain the same? Will the success rate decrease? Will the risks increase? Will the recovery period be longer? 5.
What is the likelihood that discomfort in my left lower back and buttocks is caused by my hip condition? Are there other possible causes? 6.
The doctor mentioned that some patients can walk without crutches after three to four days post-surgery and return to normal activities within three months.
Is this the average experience for most patients? I have seen online reports of recovery taking three to six months, with painful rehabilitation, and some still experiencing pain after three months, which makes me very concerned.
7.
The rehabilitation clinic's description of prolotherapy mentions "tissue repair" effects.
Is there evidence that prolotherapy has improved outcomes for individuals with labral tears of the hip joint? 8.
Could pregnancy exacerbate the existing labral tear of the hip joint? If surgery is performed and recovery is achieved before pregnancy, is there a possibility of recurrence after childbirth?

Yū, 20~29 year old female. Ask Date: 2022/11/26

Dr. Zhan Xian reply Orthopedics

Hello, you can ask your surgeon about your concerns.
There is still a possibility of rupture worsening.

Reply Date: 2022/11/26

More Info

Understanding hip labral tears is crucial for anyone experiencing hip pain, especially if it has persisted for an extended period. A hip labral tear involves damage to the cartilage that surrounds the hip joint, which can lead to pain, instability, and a range of other symptoms. In your case, the journey through diagnosis and treatment has been complex, and it’s understandable to have many questions regarding your condition and the potential treatment options.

Symptoms and Diagnosis
The symptoms of a hip labral tear can vary but often include:
- Pain in the hip or groin area
- A catching or locking sensation in the hip joint
- Stiffness or limited range of motion
- Pain that worsens with prolonged sitting or standing
- Discomfort during activities such as running, jumping, or even walking
Given your history of physical therapy and the MRI findings indicating a labral tear, it seems that the diagnosis aligns with your symptoms. The presence of the AS gene and the mild inflammatory markers suggest that there may be underlying conditions contributing to your hip pain, which is worth monitoring.

Treatment Options
1. Surgical Intervention: The recommendation for arthroscopic surgery to repair the labral tear is common, especially if conservative treatments have not provided relief. The surgery aims to restore the function of the hip joint and alleviate pain. While there are risks associated with any surgical procedure, including the potential for degenerative joint disease or avascular necrosis, these complications are relatively rare. The likelihood of developing osteoarthritis after surgery is generally lower than if the tear is left untreated, especially in younger patients.

2. Conservative Management: If you choose to manage your symptoms conservatively, physical therapy and regenerative treatments like PRP (Platelet-Rich Plasma) therapy can be beneficial. These treatments may help reduce inflammation and improve function, but they may not fully resolve the underlying issue. Many patients find that they can manage their symptoms effectively with lifestyle modifications and targeted exercises.

Recovery and Prognosis
1. Post-Surgery Recovery: Recovery times can vary significantly among individuals. While some may return to normal activities within a few weeks, others may take several months. Factors influencing recovery include the extent of the injury, the individual’s overall health, and adherence to rehabilitation protocols. It’s essential to have realistic expectations and to follow your surgeon's recommendations closely.

2. Long-Term Management: If you opt for conservative treatment, maintaining a low-impact exercise routine (like walking or cycling) can help manage symptoms. However, it’s crucial to listen to your body; if activities exacerbate your symptoms, it may indicate a need for further evaluation or a change in your treatment plan.

3. Impact of Delaying Treatment: Waiting until pain becomes more severe before seeking treatment can complicate recovery. Early intervention often leads to better outcomes, and delaying treatment may increase the risk of further joint damage or chronic pain.

Other Considerations
- Referral Pain: The discomfort in your lower back and buttock could indeed be related to the hip joint, but other factors such as muscle imbalances or referred pain from the spine should also be considered. A thorough evaluation by a specialist may help clarify these connections.

- Pregnancy Considerations: Pregnancy can place additional stress on the hip joints, and while it may not directly worsen a labral tear, the hormonal changes and physical demands of pregnancy can lead to increased discomfort. If surgery is performed and recovery is successful, many women can have healthy pregnancies; however, it’s essential to discuss any concerns with your healthcare provider.

Conclusion
Navigating a hip labral tear requires a comprehensive understanding of your symptoms, treatment options, and the potential for recovery. Engaging in open discussions with your healthcare team about your concerns and treatment preferences is vital. Whether you choose surgery or conservative management, the goal is to restore function and improve your quality of life. Remember, each case is unique, and what works for one person may not be suitable for another, so personalized care is essential.

Similar Q&A

Understanding Hip Labral Tears: Symptoms, Treatment, and Recovery Concerns

Symptoms: Right hip labral tear, swelling in the right calf, and left-sided back pain. Since I was 15 years old, during my first year of high school, I noticed pain near my right hip joint after running too intensely. Initially, I didn't think much of it and continued to exe...

Dr. Shi Guozheng reply Orthopedics
A labral tear does not cause calf pain or back pain, and it is not suitable for surgery. It is necessary to consult a surgical specialist and consider visiting another medical center that specializes in sports injuries or hip joint issues to evaluate the possibility of recovery, ...

Understanding Hip Labral Tears: Symptoms, Diagnosis, and Treatment Options

Hello, Doctor. Last year, I fell from a height of 3 meters while lifting heavy objects. Since then, I have experienced swelling on the outer side of my left hip joint, and there is a clicking sound on the inner side that is painful. I have been receiving treatment in a rehabilita...

Dr. Shi Guozheng reply Orthopedics
Further evaluation with ultrasound or MRI can be considered. It's advisable to have a physician assess the situation before making any plans regarding potential regrowth, as some conditions may not allow for regrowth and may require surgery.

Understanding Femoroacetabular Impingement and Labral Tears: Symptoms and Treatment

Doctor, I was recently diagnosed with femoroacetabular impingement and a labral tear of the hip. Initially, I only experienced pain in my left groin, but over time, it has gradually developed into stiffness and pain in my left buttock and the back of my left thigh, especially whe...

Dr. Shi Guozheng reply Orthopedics
1. It is possible. 2. Consult an orthopedic surgeon for advice; surgery may be necessary.

Post-Op Day 2 After Hip Labrum Repair: Understanding Pain and Recovery

Dear Dr. You, I sustained a sports injury last September, resulting in a left hip labral tear. After unsuccessful conservative treatment, I underwent hip arthroscopy for labral repair on August 12. It has been two days since the surgery, and I still experience pain when getting ...

Dr. You Dianqi reply Orthopedics
Hello: Although arthroscopy is considered minimally invasive, it is still classified as a surgical procedure. Some comments found online may not accurately reflect individual conditions, mobility, or surgical techniques, and the influence of advertisements can create a misleading...