Hip Labral Tears
Hip labral tears occur when the labrum or fibrocartilagenous ring that surrounds the hip socket is injured. Pain, stiffness, and other disabling symptoms of the hip joint may be experienced when labral tears are present.
The hip joint is located at the meeting point of the rounded head of the femur and the cavity-shaped acetabulum of the pelvic bone. This ball and socket joint bears the weight of the body as well as the tremendous forces generated with activities such as walking, running and jumping. As one of the most flexible joints in the body, the hip allows a greater range of motion than all other joints with the exception of the shoulder.
The hip joint is stabilized and secured by the labrum a fibrocartilaginous ring that surrounds the hip socket or acetabulum. The labrum adds to and deepens the socket helping to keep the femur in place. It also acts as a seal around the head of the femur, to maintain the fluid pressure of the hip joint. An intact labrum is essential for the normal function of the hip joint.
Hip labral tears can be the consequence of an acute injury as produced by a fall or an accident, but are more commonly seen as the result repetitive trauma to the hip joint. Oftentimes flaws in the anatomy of hip joint components combined with repetitive small injuries can lead to a gradual onset of the problem.
Factors that increase the risk of developing hip labral tears may include:
- Traumatic injury to the hip
- Repetitive stress injuries from activities that require extreme motions such as twisting, cutting, or running.
- Degenerative diseases such as osteoarthritis
- FAI (femoroacetabular impingement)
- Legg-Calve-Perthes Disease
- Slipped Capital epiphysis
- Capsular laxity/hip hypermobility
Symptoms of hip labral tears can include pain in the groin or front of the hip during physical activity or with bending and rotation of the hip. Painful clicking or “catching” with hip movements may also be experienced. There can be joint stiffness, a feeling of instability, as well as pain that can radiate to the buttocks, along the side of the hip, and even down to the knee. The symptoms may worsen following long periods of sitting, standing, or walking. Hip labral tears can be debilitating, limiting the range of motion in the joint and curtailing an individual’s participation in both everyday as well as recreational activities.
Diagnosis of the condition begins with a history and detailed physical examination. The doctor will evaluate for hip labral tears by moving the leg and hip joint through a series of specific movements. If pain in the joint is relieved with the injection of an anesthetic, the problem could be a labral tear. In order to more definitively locate the source of the problem and to rule out other conditions, imaging tests including a specialized MRI of the hip and x-rays may be ordered.
Initially non-surgical therapy may be prescribed. This can include nonsteroidal anti-inflammatory drugs, activity modification, physical therapy to strengthen muscles, and if needed a steroid injection to the joint. If after several weeks there is no improvement, then surgery on the labrum to repair or debride it may be recommended. The exact surgical procedure will depend on the severity of symptoms, characteristics of the tear, and if any associated conditions require treatment.