Potential Playoff Impact of Percy Harvin's Hip Injury and Postoperative Status

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistJanuary 10, 2014

USA Today

A "slight tear" in Percy Harvin's acetabular labrum cost the Seahawks wideout almost all of the 2013 season, and until recently, it threatened his postseason as well.

What a difference a couple of weeks makes.

According to Liz Mathews of ESPN 710 Seattle, Harvin "absolutely expects to play on Saturday" in the Seahawks' playoff matchup against the New Orleans Saints.

Yet playing is one thing.

Playing effectively is another.

Now more than five months out from the original injury announcement, could Harvin's labral tear still affect his play this week—even after going under the knife to address the issue earlier this year?

Let's take a closer look to find out.


What Is the Hip Labrum?

The "hip" marks the point where the femur (or thigh bone) meets the pelvis. Specifically, the rounded head of the femur sits within the cup-like acetabulum—or hip socket.

Around the rim of the acetabulum sits a cartilaginous labrum.

By encircling the acetabulum, the labrum deepens the cup inside which the head of the femur rests. As a result, the femur sits more snugly and is less able to fall out of the socket—a dislocation.

The head of the femur (represented by a yellow circle) lies within the acetabular labrum, seen here as a red arc.
The head of the femur (represented by a yellow circle) lies within the acetabular labrum, seen here as a red arc.Wikimedia Commons (with edits by the author).

For a better picture, imagine a beach ball sitting inside an inner tube. The ball is the head of the femur, and the inner tube is the labrum.


What Happened to Percy Harvin?

Just like any other soft tissue in the body, the acetabular labrum can tear.

Tears often occur as a result of acute, extreme trauma to the hip or over long periods of time in a "wear and tear" fashion.

Hip dislocations—when the femur slips out of the acetabulum—can damage the labrum.
Hip dislocations—when the femur slips out of the acetabulum—can damage the labrum.Wikimedia Commons

Femoroacetabular impingement (FAI)—an underlying condition where the femur and acetabulum do not align properly due to misshapen bones—may also play a role in some cases. In FAI, abnormal pressure between bone surfaces can lead to chronic, degenerative labral injury.

The exact nature of Harvin's tear remains unclear, as precise medical details are unavailable to the public.


What Is Hip Labrum Repair Surgery?

Recently, orthopedic surgeons are using an arthroscopic approach to repair hip labrums more and more frequently.

In other words, by inserting small cameras and other instruments into the joint itself, doctors can avoid the morbidities associated with open hip surgery.

Once inside the joint, a surgeon can not only directly visualize the type and extent of labral damage but also repair it. Labral repairs usually consist of trimming away frayed, damaged tissue or reattaching the labral ring to the bone, depending on the injury type.

The surgeon can also repair any bone damage that may exist.

Unfortunately, recovery times come in the form of months, not weeks. Even after the advent of the less invasive arthroscopic technique, proper rehabilitation protocols remain long and complex. The exact timetable depends on the extent of damage within the joint prior to the operation.


What About Harvin's "Little Procedure" Late in the Season?

In early December, Pro Football Talk's Josh Alper reported Harvin underwent a cortisone injection in his postoperative hip. Cortisone, a steroid—no, not that kind of steroid—helps temporarily relieve swelling and pain at the injection site.

Regrettably, the necessity of the injection implies the existence of significant postoperative inflammation. The causes of such a complication range from relatively benign to very, very serious.


Will Harvin Be Effective Saturday? Next Week? Next Year?

At this point, it remains very difficult to project Harvin's future performance from the outside looking in, and it gets murkier the further one looks.

While he may once again possess his straight-line speed, changing directions and cutting pose a different set of challenges to a rehabbing hip.

Whereas sprinting forward mainly employs mere hip flexion and extension, planting and cutting require effective internal and external hip rotation, and thus different types of femur movements within the acetabulum.

With that in mind, Seahawks fans should pay close attention to Harvin's ability to shake defensive backs, not just outrun them.

If the wideout can maintain a sharp route-running ability throughout the entire game, it may indeed signify a sufficiently healthy hip. In such a scenario, he could even make it through the remainder of the Seahawks' postseason without difficulty.

On the other hand, coach Carroll may be intentionally hyping up his wide receiver's health only to use him as a decoy on Saturday. The scary possibility that his hip troubles represent the beginning of a chronic battle, while not necessarily likely, also remains.

Either way, the picture will look blurry for some time.

After all, while the dramatic switch from overwhelming doubt surrounding Harvin's hip to near-certainty is likely a result of excellent care by the Seahawks medical staff, we haven't seen him perform yet. 


Dr. Dave Siebert is a resident physician at the University of Washington. He plans to pursue fellowship training in Primary Care (nonoperative) Sports Medicine.


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