Interview with Dr. Tim Bert: arthroscopic repair of hip labrum tears

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3 жыл бұрын

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- Dr. Tim Bert is a board-certified orthopedic surgeon who treats patients with shoulder, knee, and hip problems. Dr. Bert is completed a fellowship in Sports Medicine, and is Board Certified in Sports Medicine.
What is the labrum and how does it get torn?
The labrum is a thick band of cartilaginous tissue that forms a sleeve around the hip. In addition to helping buffer force, the labrum helps hold the ball in the socket.
What does a torn hip labrum feel like?
Labral tears in the hip cause a sharp pain that usually radiates to the groin. The pain is present most of the time right after injury, and is less frequent after a few months. This is in contrast with arthritis, which starts small and grows, and is associated with loss of range of motion and worsens with age. A labral tear will often produce a click when walking.
Can a torn labrum in the hip heal itself? IF not what can be done?
No. Labral tears usually do not heal themselves. Small tears can be made not to hurt with rest and by strengthening the muscles around the hip. Larger tears are likely to require intervention. Studies have shown that physical therapy is helpful for a labral tear in 20% of cases; that means 80% of the time it is not effective. If the labral tear is serious then surgical treatment should be considered by a doctor with experience in treating labral tears of the hip. If the tear is left untreated your hip is more likely to develop arthritis, and eventually require total hip replacement.
Will an MRI show a torn hip labrum?
Yes. But an X-ray may not. X-ray shows bone while MRI shows soft tissue. So, X-ray will not show a labral tear directly. However, x-ray may show bone spurs associated with a labral tear, making it a useful first test. An MRI will show the tear and it’s size directly.
Will cortisone injection help torn hip labrum? Stem cell treatments?
Yes, but only for a short time. Injections are often used to get an athlete through the season. Injections are temporary, and do not change the need for surgery. If the tera is bad enough for surgery, and your schedule permits, then just have the surgery.
What is the labral tear hip surgery success rate?
Very high.
Surgery animation ( • Hip Labral Reconstruction )

Пікірлер: 37

@ChrisLee66 Жыл бұрын

You asked every single question I had. Thank you for an outstanding video.

@BestPracticeHealth Жыл бұрын

You are welcome! And thanks for the comment.

@sararosechacon3469 Ай бұрын

Same. Thank YOU.

@cal2780 10 ай бұрын

I'm glad I found you. I'm an active, healthy 72 year old woman. Since childhood, I've roller skated, biked swam. Now I hike 3 miles in an hour and a half (forest preserves), bike 2-5 times a week around my community, 8 miles in under an hour. 20 miles on country bike trails in an hour and a half once a week, swim 5 days a week (when the weather isn't bike friendly) I lift weights 3 x a week and inline skated from1993 until 2 years ago. I'm supposed to be scheduled for anterior hip replacement surgery in 3 months. Osteoarthritis, bone spurs and torn labrum. Oh.. I was thrown from a horse when I was 13 and landed on the right hip. I've done decades of therapy, acupuncture, dry needling. I stopped riding my bike for one month, RICE and it helped a bit. I started swimming for 45 minutes, 4 times a week again, one 8 mile bike ride last Friday. I'm doing exercises throughout the day ( glute squeeze, partial squats etc). Ortho said because of my age, arthroscopy wasn't a good idea. He did a comparative xray February and August. He said I'll bounce back fast due to my exercise and healthy diet ( organic and from scratch meals). So, what I took away from your video, surgery is my best option?? Any comments?

@riseup3117 7 ай бұрын

outstanding video from someone who is suffering from a labral tear

@jamaicazipfel9088 2 ай бұрын

I was misdiagnosed by a ARNP after a work injury at the casino 3 1/2 years ago that made my treatment terrible. Everything you said is what I've been experiencing and I'm going to sue the provider after I get confirmation from my 3rd doctor. Thank for this video, I'm going to refer to this video to my case.

@BestPracticeHealth Ай бұрын

It's really tough to see delayed diagnoses; they can cause so much unnecessary suffering. I remember my mom, may she rest in peace, endured six months of severe discomfort from a pelvic fracture that went unrecognized after a car accident. I’m relieved to hear that your hip pain has been correctly identified as a torn labrum. Fortunately, many orthopedic surgeons today are achieving excellent outcomes with arthroscopic repair. Wishing you the best of luck with your treatment.

@jamaicazipfel9088 Ай бұрын

@@BestPracticeHealth If it wasn't for that fact I got misdiagnosed it's wouldn't be in the chronic stage 3 1/2 years later, due to the ARNP not listening to my symptoms in the beginning. I thought I had a glute medius tear originally. I was a former LMP and told her my pain deeper in my hip and was dismissed. I got addressed but this was a work injury i got essentially screwed over on by my former job/ their provider.

@mistynutter2155 Жыл бұрын

Thank you for this video!! I was researching hip pain about six months ago and stumbled on this video. I was having all the symptoms, went and got it checked out and I have surgery in January! I just thought I’ve been being a baby about how bad my hip was hurting and can’t stand it anymore! So glad I stumbled upon this video.

@BestPracticeHealth Жыл бұрын

Awesome! You are so welcome. Make sure your surgeon does a lot of labral tear repairs. There is a high revision rate with inexperienced surgeons.

@elmalloc Жыл бұрын

I have an anterior hip labral tear. I've had groin pain for about 8 months, was walking about 10-15 miles at a time once a week before this, I'm thinking my long distance walking caused it. I used to run 3 miles a day. I'm 42 now. I've got hip/back pain also, the spine doctor says go back to PT. I want to run again, I don't think I"m part of that 20% since I've been in pain for 8 months and been on pain meds/PT. It took the Cleveland Clinic 7 months to agree to giving me an MRI on my hip, I'm not happy about this. Couldn't walk around the house without pain for 5-6 months. I want a hip arthroscopy but I want to find someone who has done a million. I'm a different person since this injury, can't garden, can't run, can't walk far, can't walk around the house without saying ow a few times a day. I hate this.

@BestPracticeHealth Жыл бұрын

You are wise to look for a surgeon with a lot of experience in this area. Very few have the necessary experience, and seeing one of the others is a waste of time and money.

@kimberlymarie9512 11 ай бұрын

I hope you are feeling better, how are you doing since surgery? I'm scheduled for my surgery in September… I want to get back to my activities as well!

@SantiagoEspaillat 11 ай бұрын

What happened

@jamaicazipfel9088 2 ай бұрын

I know exactly what you mean. Mine was a work injury and I was a runner and poe dancer as well. Very active. I haven't ran or danced in over a year due to this pain getting worse. Even my job I can't do a full 8 hrs. I'm 38. I got this when I was 34. I'm about to go to a great sports therapy doctor and I'm excited to finally addressed this.

@krystynacollier57 9 ай бұрын

Great learning insights. Thank you

@BestPracticeHealth 9 ай бұрын

Glad it was helpful!

@Vision-sp8zf 7 ай бұрын

I had 5 years of significant pain, mainly during sport (football), however, it would also manifest whilst standing or climbing off the sofa. It started aged 44 and during attempts to seek medical assistance, I was told on countless occasions to 'give up sport', which served to annoy me. At 49yrs old, I've just had the operation completed and I'm now on the comeback trail I will play football again, I will run distance again, I will sprint again, I will box again.

@jessicadunham9472 2 ай бұрын

What a great interview! So informative. My daughter has been having chronic pain since a weightlifting squatting injury. She is a very competitive sprinter and has missed her entire track season now because of this. I’m very curious to know what’s actually going on in her hip. No one will give her an X-ray or MRI but I think she needs one at this point. The pain is not getting better only worse with any exertion. Is there anyone in the Kansas City area that you would recommend or know of that has these expertise? Even if she doesn’t need surgery, it would be great to go to someone who would know how to fix it! Thanks!

@BestPracticeHealth Ай бұрын

I'm sorry to hear about your daughter's injury. Here’s a brief overview of how you might proceed based on the situation: Obtaining an MRI is crucial as it will provide a detailed image of the hip's soft tissues, confirming the presence and extent of a labral tear, and will also assess the degree of any arthritis in the hip joint. This information is essential for determining the best treatment approach. Once the MRI is done, review the written report with your doctor. The next step is to choose the Right Specialist. If she has a Labral Tear with Little or No Arthritis then you want an orthopedic surgeon who specializes in sports medicine or hip preservation and has significant experience in arthroscopic labral repairs would be ideal. As you mentioned, seeking a surgeon who performs a high volume of these procedures (e.g., at least 100 arthroscopic labral tear repairs a year) can often lead to better outcomes due to their specialized skills and experience. If he MRI report describes Moderate to Severe Arthritis ---regardless of whether or not she has a labral tear--- the treatment strategy might lean more towards joint replacement rather than preserving techniques. Finding an orthopedic surgeon who is recognized as Best Practice Certified for total hip replacements ensures that the surgeon follows the highest standards of care and stays updated with the latest techniques and technologies in joint replacement surgery. After the MRI, consulting with the appropriate orthopedic surgeon will provide a detailed discussion about the best surgical options based on the specific findings and her overall health, activity level, and goals. It’s important to choose a surgeon and facility that not only have expertise in the specific procedure needed but also provide a good support system for pre-surgery preparation and post-surgery rehabilitation.

@litespeed7715 21 күн бұрын

My 22 year old niece has a hip labral tear. We just got the diagnosis after two years of being gas lit and misdiagnosed. The doctor botched the contrast injection during the original MRI w/contrast. The radiologist says the hip is normal and a false negative result gets put into the records. The second MRI of her hip showed a big labral tear. The techs showed my niece both MRI's side by side and all the medical staff were agreeing that the first MRI was flawed. She has been referred to a hip specialist. He is a board certified MD who 'specializes in advanced hip arthroscopy for ischiofemoral impingement, femoroacetabular impingement (FAI), labral tears, hip preservation, and anterior total hip arthroplasty.' What questions do we ask him? Do you have any doctor recommendations in Florida (bonus for Northwest Florida)? I'd like to get the best outcome for her. You've been generous with your time answering questions. Thanks for sharing your knowledge.

@aaaaaa-hd7zp 8 ай бұрын

This was great information. I suspect I had a labrum tear a week ago 🙁

@BestPracticeHealth 8 ай бұрын

Yikes! Most heal on their own. If not, seeing a doctor for a physical exam is next. Pay special attention to whether the doctor can move your hip with you relaxed to replicate the pain. If so, Xray is next. If the x-ray shows less than moderate arthritis then MRI is the next step.

@aaaaaa-hd7zp 8 ай бұрын

@@BestPracticeHealth thank you. Yes I have a Drs appointment for next week. There is no pain walking, just laying down trying to lift my knee and when I turn my leg suddenly. I really hope it will heal on its own. 🙏

@jenniferdurocher4193 7 ай бұрын

If the labrum doesn’t have the blood supply to heal on its own, why will it heal from the surgical trauma?

@BestPracticeHealth 6 ай бұрын

Great question!! The labrum of the hip is a ring of cartilage that surrounds the acetabulum (the socket of the hip joint) and helps to stabilize the joint. As you note, the blood supply to the labrum is limited, which limits its ability to heal on its own after an injury or surgery. But the labrum does have some blood supply. The outer part of the labrum has a better blood supply than the inner part. This means that tears or injuries to the outer part of the labrum may have a better potential for healing compared to injuries to the inner part. However, even with a better blood supply on the outer part, the overall limited blood flow to the labrum means that healing can be slow and sometimes incomplete. Labral tears, depending on their location and severity, can sometimes heal with conservative treatment like physical therapy, rest, and pain management. However, more significant tears or those not responding to conservative management may require surgical intervention. Arthroscopic surgery can be used to clean up the torn part of the labrum, making it easier to get whatever healing the tissue can offer.

@scottpreston3016 5 ай бұрын

Can you recommend a Orthopedic Hip specialist for Labral Tears (with high volume) in the Louisiana?

@BestPracticeHealth 3 ай бұрын

absolutely. Where in Louisiana? Really the key to the endoscopic labral tear repair. Surgery is the experience of the surgeon. It’s clear that there’s a lot of people doing this operation out there. That should not be. You need an expert. It’s worth looking up the right person and getting the right reputation. Often, if you know an orthopedic surgeon in the community, they know the name of the person doing most of them.

@rickkane8043 Жыл бұрын

I got this surgery over 12 weeks ago they put 5 anchors and repaired my labrum and fix my pincer and cam lesion but until now I can't still walk without using 2 crutches still got a lot of pain in my hips and also pain in my knee. Prostrated with the results. My doctor ordered a hips aspiration to check the fluid on my hips but during the procedure they can't get a fluid. I don't know what wen wrong. I hope my doctor have some answers or solutions been a while I'm stuck at home.

@BestPracticeHealth Жыл бұрын

What a bummer! I hope things improve. The "salvage" surgery for failed labral tear repair is total hip replacement. If you are not improving I would see an orthopedic surgeon who specializes in joint replacement.

@umit777. Жыл бұрын

What is going .How are you now?

@damonmelendez856 5 ай бұрын

Can a labral tear lead to posterior pain?

@BestPracticeHealth 3 ай бұрын

this is Dr. Lieberman. My background is in neurosurgery, not orthopedic surgery, so I don’t really know for sure. Having said that, I think the answer is definitely yes. I’ll remember to ask Dr. Burt the next time I see him.

@aleksandartasic7652 Жыл бұрын

High volume where patient is just a number. Hm, yep. Thats how butcher shop does it. Interesting, how about some data on successful return to sport at pre existing pre procedure levels? Peer reviewed not self manufactured. Have to go back in….? Cash cow baby.

@BestPracticeHealth Жыл бұрын

In the decades I've been following surgical outcome data one thing I've noticed without fail is that surgical volume is inversely correlated with complications. In other words, the more you practice, the better you play. On the outcome study, that would be great data! How would that work? Who would define the pre-existing level of play and how would it be measured?

@Laurierecovers 9 ай бұрын

suffering 8 yrs. Now they want to inject. HELP from Ontario. It gives out, or locks, pain down the leg. Groin pain after walking a short distance. MRI of pelvic show nothing.

@BestPracticeHealth 9 ай бұрын

Yikes! Hip pain for the past eight years, which has not only affected your mobility but also caused significant discomfort, and it sounds like they have not given you a solid diagnosis. I would be frustrated too! Based on your description of symptoms, including hip instability, pain radiating down your leg, and particularly the discomfort in your groin after walking short distances and a negative MRI, I suspect that your condition might involve an issue with the hip labrum. Despite the inconclusive findings from the MRI, it's important to note that MRI results can sometimes be misleading, especially in cases involving labral tears. A negative MRI doesn't entirely rule out this possibility. Given the high suspicion of a labral tear and your ongoing symptoms, your doctors should consider a contrast injection into the painful hip joint, followed by another MRI imaging session. The introduction of contrast during the procedure enhances the sensitivity of the MRI, making it more capable of detecting subtle abnormalities like labral tears. This injection can be administered by the radiologist. However, it is crucial to ensure that the interpreting radiologist has specific expertise in musculoskeletal radiology to minimize the risk of missing any potential labral tear. I understand that this situation is challenging and can be overwhelming. Please rest assured that you are not alone in this journey. Your perseverance and proactive approach to seeking answers are commendable. I genuinely hope that this approach will explain your hip pian. If you do have a labral tear, it can probably be repair through an arthroscopic approach and the pain relieved. Please do not hesitate to reach out and update me on your progress. I am here to support you throughout this process.