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Hip Labral Q&A: How Long Should I Wait to Have Surgery?

Ginger Garner PT, MPT, ATC, PYTHip Labral Q&A: How Long Should I Wait to Have Surgery?

Question:

Dear Ginger, In your opinion is waiting longer until the pain is unbearable better than doing it (having HLI surgery) while the pain is minimal?

I ask this because so many surgeons and PT’s say “theoretically” waiting is no big deal because you aren’t causing more harm to the tear. They all seem to say, it’s our choice (on whether or not to have surgery).

I don’t see how that is true based on that fact that other body parts start aching acting affected. My pain is currently like a bad menstrual cramp, however if I overdue it then I can feel the pain a bit more.

I’m just curious as to your thoughts if sooner is better than later?

Answer:

Kate*, That is an excellent question! And of course, it is one that is not easily answered. It is normal to have some fear surrounding surgery, because naturally, you want to be better off than before surgery.

However, I can give you a couple of points to ponder that will help you make informed conclusions:

  • Waiting CAN cause more damage if the research and theory on the hip seal (pressurization) is true (and I support the theory at present, based on current research).
  • Waiting CAN be a plus because technology and research evolves almost DAILY. The number of research papers published in HLI have exponentially increased in the last 3 years alone (I have the exact numbers on that as I’ve been following the scientific literature on HLI since 2010). This means that had I not waited the three years to have surgery I could’ve ended up with a psoas release and a labral debridement, which with my specific bony condition/dysplasia, would have been disastrous for long-term outcomes.

Also, your surgical prognosis will be based on many factors – which could be a great (but lengthy) blog post one day.

Some of those include:

  1. presence or level of dysplasia,
  2. presence and severity of femoral and/or acetabular anteversion/retroversion,
  3. chronicity of issue,
  4. location of labral tear and severity (Is the hip seal “broken?”),
  5. state of existing tissue (e.g. psoas thickening and tendinopathy, present in many chronic cases of HLI, presents a SIGNIFICANT barrier to recovery and can increase risk of retear after surgery), and,
  6. state of muscular balance and patterning (imbalance in patterning can greatly increase loads on the labrum).

This isn’t an exhaustive list, but it’ll get you started.




 I hope this helps Kate!

Past Posts in the Series:

Hip Labrum Q&A: How Long Does Recovery After Surgery Take? 

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