Detroit Pistons’ Killian Hayes hip injury: Why he may not need surgery to recover

Detroit Free Press

Omari Sankofa II
| Detroit Free Press

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Killian Hayes’ rookie season came to a sudden halt Monday night, after the Detroit Pistons‘ point guard suffered a labral tear in his right hip against the Milwaukee Bucks. 

He took one long stride with his right leg while hustling to defend a pass in transition (see video above), and immediately fell to the ground in pain, clutching his right hip area.

The severity and a recovery timetable has not been released by the Pistons.

The team and Hayes have a decision to make: Rehab his injury, see how the hip reacts and potentially bring him back more quickly, or have him undergo surgery with a potential six-to-seven month recovery. The latter option would end his rookie season, but could be an inevitability depending on how he responds to rehab. 

What does the injury mean to his future?

Dr. Alex Johnson, an assistant professor of orthopedic surgery at Johns Hopkins, said Wednesday his first recommendation is always to try rehab first when his patient has a labral tear — a lining of the hip socket that helps to stabilize the hip. Beyond the obvious benefit of avoiding surgery, the injury itself doesn’t always require surgery to heal. It largely depends on the severity of the tear. 

“Sometimes you can try is things like injections into the hip, like some lidocaine or cortisone or even things like PRP into the hip joint, to try to get the inflammation to go down and try to get some pain relief so that you can then rehab the hip and see if you can get it better,” Johnson said. “In most of the time, if I have a patient that has a labral tear, they come in with an MRI and they have that evidence of a labral tear in the MRI, I almost always send them to physical therapy first to see if they can rehab the hip and see if they can get it feeling better with therapy.”

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Hip labrums are prone to tearing if the patient has a femoroacetabular impingement, or FAI for short — which, in layman’s terms, means the bones in the hip are shaped in a way more likely to tear. 

“Usually the way it presents is that people have groin pain and it usually comes on gradually, or you have aching groin pain stuff,” Johnson said. “And then you get X-rays and you see that their hips look kinda funny on the X-rays, and then you get an MRI and it shows that they have a labral tear.” 

If Hayes does have surgery, Johnson said it would not only address the torn labrum, but the possible FAI that led to the labrum tearing to begin with. Johnson said Hayes would likely be on crutches for a couple of weeks, begin rehabbing and working on his range of motion for six weeks and strength work after six weeks. After three months, the labrum is generally healed, and Hayes would be able to start running and eventually easing into more athletic abilities such as pivoting and cutting. 

Johnson added that without seeing Hayes’ MRI, it’s tough to pinpoint what the best course of action should be or how it will impact his career.

The hip labral tear injury has precedent in the NBA, and has been career-altering depending on its severity.

In 2017, Boston Celtics guard Isaiah Thomas suffered a hip injury during a game on March 15, and missed two games before returning. Boston initially characterized the injury as a right knee bone bruise for their 28-year-old star.

In Game 2 of the Eastern Conference finals, Thomas sat out the second half with an injury. The Celtics initially called it a right hip strain — as the Pistons did with Hayes on Tuesday — but later announced it was a re-aggravation of a right femoroacetabular impingement with labral tear. Thomas missed the rest of the playoffs. 

Instead of immediate surgery, Thomas opted to rehab his injury. But he hasn’t been the same player since the injury. After emerging as one of the NBA’s best scorers and making the All-Star team in 2016 and 2017, he appeared in 84 games over the next three seasons and is currently unsigned. He ended up having hip surgery last year.

The fate of Hayes, who is 19 years old with seven NBA games of experience, is of course unknown. Other players who have suffered labral tears have gone on to enjoy successful careers.

Spurs All-Star LaMarcus Aldridge tore his hip labrum when he was a freshman at Texas, rehabbed it instead of having surgery, and had a strong sophomore season. He had surgery for another labral tear in 2012, but has otherwise enjoyed a relatively healthy and successful career. 

On the extreme end, Miami Dolphins quarterback Tua Tagovailoa dislocated his hip while at Alabama in 2019 and tore a portion of his labrum more uncommon for athletes to tear.

After Monday’s game, Hayes was listed as doubtful for Wednesday’s game against the Bucks — a potential sign his injury is on the less-severe side. 

If Hayes’ injury is a labral tear associated with FAI, Johnson said because of his age, the prognosis to resume his career as intended should be good. 

“Hip stuff is very nuanced,” Johnson said. “A lot of it just depends on the exam and the individual.”

Contact Omari Sankofa II at Follow him on Twitter @omarisankofa. Read more on the Detroit Pistons and sign up for our Pistons newsletter.

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