York, ME (207) 363 3490 | Portsmouth, NH (603) 431 1121

20Hip Care
10Hip-Conditions and Injuries
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Deep Gluteal Space Syndrome
Labral Tears
Psoas Impingement (Internal Snapping Hip)
PVNS
Trochanteric Bursitis
10Hip-Treatment and Surgeries
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Reconstruction
Labral Repair
Nanofracture
Psoas Release
Trochanteric Bursa Debridement
33Knee Care
13Knee Conditions and Injuries
ACL Tear
Cartilage Injury
Discoid Meniscus
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Osteochondritis Dessicans
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
20Knee Treatment and Surgeries
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
Medial Patellofemoral Ligament (MPFL) Reconstruction
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Knee Replacement (MAKO)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Total Knee Replacement (MAKO)
Trochleoplasty
20Shoulder Care
10Shoulder-Conditions and Injuries
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
10Shoulder-Treatment and Surgeries
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

LABRAL DEBRIDEMENT
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 (similar to a bumper), 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 who do not improve with non-surgical treatment, Dr. Welch may recommend surgical intervention.If surgery is necessary, Dr. Welch usually recommends an arthroscopic approach to the hip using two or three small incisions. During surgery, Dr. Welch introduces a camera into the hip through one incision and surgical instruments though the other incisions. Two common procedures performed for labral tears include labral repair and labral debridement.Labral Repair is performed for patients who have a clean tear in the labrum. During surgery, Dr. Welch uses an instrument to pass sutures around the torn labrum and then secures the sutures down to the hip socket with suture anchors (medical screws). The goal of labral repair is to restore the normal function of the labrum and prevent further damage to the hip joint.

Labral Debridement is performed for patients who have a partially torn labrum with a complex pattern. Complex labral tears may not be amenable to labral repair. If the labrum cannot be repaired, Dr. Welch uses instruments to remove the damaged part of the labrum and cleans the edge of the remaining labrum (“debridement”).

Postoperative Plan

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

Following surgery, Dr. Welch 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).