Expert hip preservation specialists at Orlando Health Jewett Orthopedic Institute are advancing all aspects of arthroscopic labral tear management, including repair and restoration using the most sophisticated techniques in minimally invasive labral reconstruction.
“Investing in leading-edge training and subspecialties, combined with our large volume of positive case outcomes, has enabled Orlando Health to become a regional center for complex hip techniques,” says Andrew Carbone, MD, an orthopedic surgeon and sports medicine physician at Orlando Health Jewett Orthopedic Institute. In December 2023, Dr. Carbone performed the institute’s first labral reconstruction.
During labral reconstruction, the hip joint is accessed through small arthroscopic incisions, then the irreparably damaged labrum is removed and subsequently reconstructed using either an autograft or allograft tendon. The goal of the surgery is to recreate the suction seal that the normal labrum created with the femoral head, sealing in the normal joint fluid and maintaining a protective fluid film layer between the ball and socket of the hip joint. Achieving this seal is crucial for preventing future hip osteoarthritis. Over time, the tendon is incorporated by the body and becomes indistinguishable from a native labrum. The advanced procedure demands expert training and a high level of surgical skill.
“The technique is complex and must be performed with precision. It can require over 36 sutures and a large graft in an extremely confined space and using arthroscopic instruments. Any tangling of the sutures can result in failure of the whole construct,” says Dr. Carbone. He utilizes a knotless pull-through technique developed by Benjamin Domb, MD, with whom he trained in Chicago.
Using this procedure to reconstruct the fibrocartilaginous tissue lining the acetabulum of the hip joint can increase a patient’s mobility, improve biomechanics and offer a return to normal hip function. Surgical candidates include patients with a previous failed or improperly healed labral repair, inadequate or irreparable labral tissue, or small or calcified labrums.
“Our team collaborates on all cases and works within an operating room dedicated solely to orthopedic surgery,” says Dr. Carbone, who is dual fellowship trained in hip preservation. “That familiarity allows us to do more complicated, innovative procedures like this reconstruction.”
Dr. Carbone works closely with institute colleagues Bruce Levy, MD, an internationally recognized specialist in complex knee and hip injuries, and Abhishek Kannan, MD, a fellowship-trained expert in shoulder replacement and hip preservation.
The experts of Orlando Health Jewett Orthopedic Institute practice at the first and only orthopedic specialty hospital in Florida, which is a premier clinical destination for high-quality, multidisciplinary orthopedic care. Orlando Health is dedicated to revolutionizing patient care with outcomes advanced by specialists skilled in the most leading-edge technologies and involved in advanced clinical research and training.
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