20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

LABRAL RECONSTRUCTION

The socket (acetabulum) of the hip joint is lined by an important ring of fibrocartilage – the labrum. The labrum is an important structure; it provides stability to the hip, lubricates the hip and also maintains a negative suction seal. Labral tears may lead to many different symptoms, such as groin pain and catching. In those patients that do not improve with non-surgical treatment, Dr. Keller may recommend surgical intervention.

If surgery is necessary, Dr. Keller usually recommends an arthroscopic approach to the hip using two or three small incisions. During surgery, Dr. Keller introduces a camera into the hip through one incision and instruments into the hip though the other incisions.

Dr. Keller performs labral reconstruction for patients who have very extensive labral damage. If the labrum is too damaged, it no longer functions appropriately. During labral reconstruction, Dr. Keller measures the length of the damaged labrum and then shapes a donor labrum to match the damaged area. Dr. Keller then introduces the donor labrum into the hip and secures it to the patient’s hip socket (using suture anchors) where the patient’s native labrum is damaged. The goal of labral reconstruction with a graft is to restore the functional anatomy of the labrum, restore the normal biomechanics of the hip, and prevent future damage to the articular cartilage in the hip.

Postoperative Rehabilitation

Following surgery, Dr. Keller recommends a guided physical therapy program with a licensed physical therapist. Early motion following surgery is very important, and Dr. Keller recommends that each patient either use a stationary bike or a continuous passive motion machine daily. Dr. Keller also recommends limited weight bearing and crutch use for 4-6 weeks after surgery. Dr. Keller may also recommend the use of a brace to help protect the hip.

Following surgery, Dr. Keller prescribes appropriate pain medication as well as an anti-inflammatory medication. Anti-inflammatory medication (such as Naprosyn) is important because it can help eliminate pain and also may prevent the formation of abnormal bone (heterotopic ossification).