Hip Labral Tears

Definition

A hip labral tear is an injury to the soft elastic tissue around the hip joint called the labrum. The hip joint is made of a ball and socket. The ball is the end of the thigh bone, also called the femur. This ball fits into the bowl-shaped socket in the pelvic bone, also called the acetabulum. Cartilage lines the socket to keep movement smooth and the joint cushioned. The labrum helps to hold the ball of your femur in place. When the this tears, it is called a hip labral tear.
Hip Joint and Cartilage
Hip cartilage
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Causes

Hip labral tears can result from wear and tear or from an injury.

Risk Factors

Factors that can increase your chances of getting a hip labral tear include:
  • Wear and tear of hip joint from different activities, such as golf or softball
  • Traumatic injury to hip
  • Twisting injuries
  • Motor vehicle accident
  • Degenerative diseases like osteoarthritis
  • Femoroacetabular impingement syndrome (FAI)
  • Legg-Calve-Perthes disease
  • Hip dysplasia
  • Osteoarthritis
  • Slipped capital epiphysis
  • Capsular laxity/hip hypermobility

Symptoms

Symptoms vary and can be mild, including:
  • Hip pain: sharp, deep, disabling
  • Locking or clicking of hip
  • Hip instability
  • Limited range of motion
  • Tenderness to touch
  • Groin, buttock, or thigh pain
  • Pain during activity

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You will likely be referred to a specialist. An orthopedic surgeon focuses on bones and joints.Images may need to be taken of your hip. This can be done with:An anesthetic may be injected to help diagnose this condition. If the pain gets better with the injection, the problem is in the joint which could be a labral tear.

Treatment

Talk with your doctor about the best plan for you. Treatment options include the following:

Medical Treatment

Common medical treatment may include:Common medical treatment may include:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Steroid injection to the joint
  • Modified activity
  • Physical therapy to strengthen muscles
Generally, this treatment is tried for several weeks. If there is no improvement, then surgery is considered.

Surgical Treatment

Arthroscopy uses a thin, lighted tube inserted through a small incision to view the injury and fix it. Small instruments are threaded through this tube. The torn labrum may be removed or sewn together. Arthroscopy uses a thin, lighted tube inserted through a small incision to view the injury and fix it. Small instruments are threaded through this tube. The torn labrum may be removed or sewn together.

Rehabilitation

After surgery, you may be fitted with a brace. This will provide support and aid healing. A therapist will work with you. The therapy will include strength exercises and a plan to increase your weight bearing.

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Prevention

There are no known guidelines to prevent a hip labral tear.

RESOURCES

Arthroscopy Association of North America
http://www.aana.org

OrthoInfo—American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

References

Bharam S, Philippon MJ. Diagnosis and management of acetabular labral tears in the athlete. International SportMed Journal. 2008;9(1):1-11.

Burnett SJ, Della Rocca GJ, et al. Clinical presentation of patients with tears of the acetabular labrum. The Journal of Bone & Joint Surgery. 2006;88:1448-1457.

Hunt DH, Clohisy J, et al. Acetabular Labral Tears of the Hip in Women. Physical Medicine and Rehabilitation Clinics of North America - Volume 18, Issue 3 (August 2007).

O'Kane J. Anterior hip pain. Am Fam Physician. 1999 Oct 15;60(6):1687-1696. Available at: http://www.aafp.org/afp/991015ap/1687.html. Accessed March 10, 2015.

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