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Hip Labral Tear

Overview

A hip labral tear involves the ring of cartilage (labrum) that follows the outside rim of the hip joint socket. Besides cushioning the hip joint, the labrum acts like a rubber seal or gasket to help hold the ball at the top of the thighbone securely within the hip socket.

Athletes who participate in sports such as ice hockey, soccer, football, golf and ballet are at higher risk of developing hip labral tears. Structural problems of the hip also can lead to a hip labral tear.

Symptoms

Many hip labral tears cause no signs or symptoms. Some people, however, have one or more of the following:

  • Pain in the hip or groin, often made worse by long periods of standing, sitting or walking or athletic activity
  • A locking, clicking or catching sensation in the hip joint
  • Stiffness or limited range of motion in the hip joint

Causes

The cause of a hip labral tear might be:

1.Trauma. Injury to or dislocation of the hip joint — which can occur during car accidents or from playing contact sports such as football or hockey — can cause a hip labral tear.

2.Structural problems. Some people are born with hip issues that can accelerate wear and tear of the joint and eventually cause a hip labral tear. This can include having a socket that doesn't fully cover the ball portion of the upper thigh bone (dysplasia) or a shallow socket, which can put more stress on the labrum.

Extra bone in the hip, called femoroacetabular impingement (FAI), can also cause pinching of the labrum, which can lead to tearing over time.

3.Repetitive motions. Sports-related and other physical activities — including long-distance running and the sudden twisting or pivoting motions common in golf or softball — can lead to joint wear and tear that ultimately result in a hip labral tear.

Prevention

If the sports you play put a lot of strain on your hips, condition the surrounding muscles with strength and flexibility exercises.

How is a hip labral tear diagnosed?

To diagnose a hip labral tear, the doctor will do a physical examination. During the exam, the doctor may ask you to move your leg or walk around. How well you can move, and any pain you feel while moving, can help the doctor with the diagnosis.

Imaging tests can also help doctors diagnose a hip labral tear. The doctor may order the following imaging tests:

1.X-rays: X-rays can alert doctors to problems with the hip bones, such as femoroacetabular impingement, or osteoarthritis, that may contribute to a labral tear and a painful hip.

2.Magnetic Resonance Imaging (MRI): This test shows more details in soft tissues. An MRI can show where a labral tear is, and how severe it is.

Complications

A hip labral tear can make it more likely that you'll develop osteoarthritis in that joint.

Treatment

The most common surgery to repair hip labral tears is arthroscopic surgery. During this procedure, an orthopaedic surgeon makes several small incisions to access the hip. With the help of a special camera device called an arthroscope, the surgeon locates the labral tear and uses surgical tools to repair it.

Medications

Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can relieve pain and reduce inflammation. Pain can also be controlled temporarily with an injection of corticosteroids into the joint.

Therapy

A physical therapist can teach you exercises to increase your hip's range of motion and build hip and core strength and stability. Therapists can also teach you to avoid movements that put stress on your hip joint.

Surgical and other procedures

If conservative treatments don't relieve your symptoms, your health care provider might recommend arthroscopic surgery — in which a fiber-optic camera and surgical tools are inserted via small incisions in your skin.

Depending on the cause and extent of the tear, the surgeon might remove the torn piece of labrum or repair the torn tissue by sewing it back together.

Complications of surgery can include infection, bleeding, nerve injury and recurrent symptoms if the repair doesn't heal properly. A return to sports usually takes 3-6 months.

How serious is a hip labral tear?

A tear in your labrum can cause pain and instability in your hip, damage other tissue and cartilage in your joint, and lead to osteoarthritis over time.

How painful is a labral tear in the hip?

For many patients, a labral tear injury causes intense hip pain that feels like it comes from a place deep within the joint. For some, this “deep” hip pain may radiate into the groin or buttocks during hip-intensive activities.

Can a hip labral tear heal on its own?

A hip labral tear won't heal on its own, but rest and other measures can help manage symptoms of a minor tear. Nonsurgical treatments include: Anti-inflammatory medications: Over-the-counter pain relievers like ibuprofen can reduce inflammation.

What happens if you leave a hip labral tear untreated?

If a labral tear is left untreated, it will lead to ongoing and worsening pain. A normal labrum is important to the normal function of the hip joint. A torn labrum leads to cartilage damage and eventual arthritis of the hip joint.

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