@Skywalker
I don’t have FAI or a torn labrum, so I can’t answer your questions - I certainly wish I could. I understand the appeal of preserving your hip - and I might try to do it myself if that were an option for me. Even so, the fact that your surgeon proposed something unexpected would definitely make me schedule at least one more consult with a different hip specialist before I made a decision about the best course of action. For comparison, I am scheduled for surgery with the third surgeon I consulted. This is pretty common.
When we read advice about choosing a hip replacement surgeon, there’s always a recommendation to choose one who performs a large number (hundreds per year) of the procedure you’re going to have - not a general orthopedic surgeon who does a small number of a variety of procedures. That’s because we understand mastery comes from repetition, doing the procedure day in and day out.
It seems to me that same advice would apply to reconstructive surgeries. Your surgeon has proposed rebuilding instead of replacing your hip. How many hip reconstructions has he done? How many in the last year? His web page says his specialty is arthroscopic shoulder reconstruction. That raises questions in my mind. That doesn’t mean he isn’t a terrific doctor. It might mean there is a better option for you.
Jamie (forum moderator) might be able to direct you to a top hip reconstruction surgeon in the greater Seattle area. She manages the BoneSmart referral database, and has very astute advice about choosing surgeons. You can tag her, if you want. At the top of this page, you’ll see a “surgeon locator” tab, where you can search the database yourself by zip code. I know 2 surgeons on that list, and they are both exceptional, so I believe it’s a reliable resource.
I appreciate how hard it is to live in pain and uncertainty. It’s worth a small delay to get this step absolutely right.
Edited to add: I have just done a search for “FAI” in the search box up at the top of the page. There are multiple threads, articles, and comments from posters with FAI, moderators and Josephine - all of whom have experience and information that will help you. A number of those posters had hip arthroscopy to address FAI, so you can read about those results and recoveries. It seems that arthroscopy doesn’t always prevent THR, however, so there are important considerations for you here.