Hip Labral Repair and Reconstruction

The hip labrum plays a vital role in maintaining stability, mobility, and a healthy cartilage surface within the hip joint. When the labrum becomes torn or damaged, patients may experience sharp hip or groin pain, clicking, locking, stiffness, and reduced mobility. For many individuals—especially athletes and active adults—hip labral repair or reconstruction can restore normal function and allow a full return to activity.

At Star Orthopedics, Dr. Andrew Dold specializes in advanced minimally invasive hip arthroscopy techniques for both labral repair and labral reconstruction. Using small incisions and a high-definition arthroscopic camera, he restores the labrum to its anatomic position, re-establishing the suction seal of the hip joint.

What Is the Hip Labrum?

The labrum is a ring of cartilage that surrounds the rim of the acetabulum (hip socket).
Its functions include:

• Creating a suction seal for stability
• Distributing joint pressure
• Protecting cartilage
• Enhancing hip biomechanics

When injured, the labrum can no longer support the joint, leading to pain and progressive damage if left untreated.

Causes of Labral Tears

Common reasons patients develop labral tears include:

• Femoroacetabular Impingement (FAI) — extra bone on the femoral head or acetabulum that pinches the labrum
• Trauma or sports injuries
• Repetitive twisting, pivoting, or flexion movements
• Hip dysplasia
• Degenerative changes or arthritis

These conditions may compromise the labrum’s structure, leading to pain and mechanical symptoms.

When Is Labral Repair Needed?

Labral repair is recommended when:

• The labral tissue is healthy enough to be preserved
• The tear pattern is repairable
• There is a desire to maintain natural anatomy
• The hip shows good cartilage quality

Repair helps restore the natural suction seal of the hip, which is essential for smooth and stable movement.

How Labral Repair Is Performed

Using arthroscopy, the entire procedure is done through small portals. You can also watch it here, visually: How Labral Repair Is Performed.

1. Visualization of the Joint

The camera shows the femoral head, acetabulum, and the torn labrum. If a pincer lesion (excess bone on the socket) is present, it is smoothed or reshaped to prepare the area for repair.

2. Passing the Sutures

A suture-passing device is used to loop strong sutures around the torn labrum.
This securely captures the tissue and prepares it for anchor placement.

3. Drilling for the Anchor

A curved 20-degree guide is used to drill tunnels precisely into the acetabular rim.
This angle ensures safe placement away from the joint cartilage.

4. Anchor Placement

Suture anchors—pre-loaded with sutures—are inserted into the drilled holes.
As the anchor is tapped into place, the labrum is gently rolled back into its natural anatomic position, restoring the suction seal.

5. Securing the Repair

Excess suture is trimmed, and additional anchors are placed as needed.
In the video, a two-anchor labral repair is completed, creating a stable, smooth, and well-positioned repair.

When Is Labral Reconstruction Needed?

Labral reconstruction is performed when:

• The labrum is severely damaged or frayed
• Tissue is missing or too weak to hold sutures
• Prior surgery has failed
• Degenerative labral tissue cannot be repaired

In these cases, Dr. Dold uses healthy graft tissue to rebuild a new labrum and restore hip stability. Reconstruction helps re-establish the suction seal and often provides better outcomes than attempting to repair poor-quality tissue.

Labral Reconstruction Technique

Reconstruction is also performed arthroscopically and includes:

• Measuring the defect
• Preparing the acetabular rim
• Sizing and shaping a graft
• Securing the graft using multiple suture anchors
• Re-creating a new, functional labral ring

The goal is to reproduce the natural labrum’s shape and function.

Recovery After Labral Repair or Reconstruction

Post-operative recovery involves:

• Weight-bearing restrictions initially
• Focused physical therapy
• Gradual strengthening of core and hip stabilizers
• Avoiding deep flexion or pivoting early on
• Return-to-sport timelines typically between 3–6 months

Patients who follow their rehabilitation plan closely achieve the best outcomes.

Benefits of Hip Labral Repair/Reconstruction

• Restores hip stability
• Reduces pain and clicking
• Prevents further cartilage damage
• Improves long-term joint health
• Enables return to sports or an active lifestyle
• Minimally invasive with small incisions and a faster recovery

Is Hip Labral Surgery Right for You?

If you are experiencing persistent hip pain, clicking, locking, or stiffness, an evaluation with Dr. Dold can determine whether labral repair or reconstruction is the right option. Early treatment can prevent worsening symptoms and help preserve your joint for years to come.