I have a labral tear in my left hip that is painful enough to consider having surgery. But I'm all for leaving it alone if it can heal on its own. What are my chances for self-recovery?

The labrum is a horseshoe-shaped bit of fibrous cartilage lining the hip and shoulder sockets. It has multiple functions so maintaining a good, healthy labrum is important.

For example, the labrum increases the size of the joint surface and the joint socket. Another term for the hip socket is acetabulum. This increase allows for a more even distribution of load across the whole joint.

Another task the labrum carries out is to act like a suction cup creating negative pressure in the joint. The seal that forms holds the lubricating synovial fluid inside the joint. The net effect is that the labrum reduces joint friction, a protective feature against degeneration leading to arthritis. When combined together, the various functions of the labrum help maintain joint stability.

Surgery is usually the recommended course of action for a symptomatic labral tear. Patients often ask if the problem can correct itself with time and rest. The answer to that question is maybe. The labrum doesn't have its own internal blood supply. Without a good blood supply, healing isn't possible.

The labrum depends on the blood vessels in the acetabulum (hip socket) and surrounding soft tissues. Someof the tiny blood vessels from these others areas reach the labrum to supply oxygen and healing nutrients.

Some areas of the acetabulum have more blood than others. So depending on the location of the labral tear, self-healing might be possible. In other words, healing may occur when the tear is closest to the best blood supply.

Based on imaging studies available, your surgeon will be able to answer this question best. The location of the tear and the size of the tear are the two main factors in the decision. Your surgeon will also evaluate your level of fitness and activity as important guides in the decision-making process.

Reference: 

Marc R. Safran, MD. The Acetabular labrum: Anatomic and Functional Characteristics and Rationale for surgical Intervention. In Journal of the American Academy of Orthopaedic Surgeons. June 2010. Vol. 18. No. 6. Pp. 338-345.

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