Sorry to hear it - hip pain sucks. I had surgery for a torn (shredded really) labrum and FAI 5 years ago after over a decade of recurring pain and trying everything to fix it. For me the result was great - I went from daily celebrex to not even knowing if there's advil in the house. I still do all the sports I love, including skiing, playing ultimate and playing tennis. I also train or have trained a lot of people with hip problems. Some were post-surgery, some pre-surgery, some trying to avoid surgery.Here's my opinions:
1. The poor outcomes are hugely exaggerated above. If you read forums, of course you'll see lots of negative outcomes - the people who have positive outcomes tend to not be writing about it on online forums. Now if you have arthritis in the joint already, then the likelihood of a poor outcome is high. But not certain. I had arthritis going in and so the surgeon also did some microfracture. I used that as motivation to be 100% committed to rehabbing properly. That meant doing all the exercises but also not returning to anything too soon. I think a lot of people jeopardize their outcomes by returning to activities too soon and without adequate strength.
2. Did they talk about Femoro acetabular impingement (FAI)? There's a high correlation between the two. If you have a labral tear of unkown origin, odds are you have FAI. Fixing the tear without addressing the FAI is not a great idea. If the surgeon you're seeing isn't considering this, then you should find a different surgeon.
3. Just because you have a labral tear, doesn't mean that's the cause of the pain. This is the challenge of imaging.They've done cadaver studies where something like 97% of hips have torn labrums. The torn labrum may just be a part of aging. The medical community doesn't yet know why some are painful and some are not. Similarly, if you have FAI, it's not a certainty that that is a problem. I read one study where they were trying to see if squatting could be a test for FAI. They had to throw out several of their healthy participants because imaging showed they had FAI.
4. Non-surgical treatment does work for some people, but not for all. I don't think it's possible to predict who can avoid surgery and get pain-free, but I think it's always worth trying first. I've had a couple of clients who were able to be pain-free and avoid surgery through a combination of proper training, good manual therapy, and avoiding certain activities. I've had other clients try the same thing and not be able to avoid surgery. If you try to avoid it - I'd suggest setting a time frame during which you'll work hard to avoid surgery.
5. When I mention activities to avoid, I think it's important to consider that effect on your quality of life. So for me, skiing wasn't an activity I was willing to give up. This will be a very individual decision. The first one I get my hip clients to avoid is squats. The deep hip flexion is not a great position for these people. Similarly, cycling can be problematic because of this angle.
Good luck with whatever route you take.
so some quick info:
1- agree 100%
2- FAI, did not meet for followup with OS. He actually specializes in arthroscopic FAI procedures I believe he was th 1st in CO to do this procedure.
3- part of the MRI and arthrogram (I assume you know what that is) they inject the socket with lidocaine and Cortisone (I love cortisone). In addition to seeing the flap tear and vertical tear, on the MRI, another test is if the cortisone and lidocaine causes the pain and other symptoms like restricted range of movement to be greatly reduced, they know where its coming from. If the pain doesn't go away, they know the pain is still being caused by something else. In my case I had rather severe groin and Psoas pain as well as quad and Trocanter pain. Almost all of it is gone Some of the pain is still in my PSoas and groin but I think those muscles were so inflamed it may take a few more days (its just been since thursday afternoon).
4-I have been dealing with this for almost 1.5 years with Message therapy, ART therapy chiropractic and traditional PT. Every time I get it under control it just comes back once I start to use it heavily.
5- Cycling and skiing are paramount. I need to do these things. Not willing to give either up. But I haven't been able to run either and even walking up steep trails is difficult. Forget sitting for longer than 1/2 hour too!