Hip Labral Tear

A hip labral tear involves the ring of cartilage, called the labrum, that follows the outside rim of the socket of 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 such sports as hockey, football, golfing and ballet are at higher risk of developing a hip labral tear. Structural abnormalities of the hip also can lead to a hip labral tear.

Cause

The cause of a hip labral tear may be:

  • 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.
  • Structural abnormalities. Some people are born with hip problems that can accelerate wear and tear of the joint and eventually cause a hip labral tear.
  • Repetitive motions. Sports-related and other physical activities — including the sudden twisting or pivoting motions common in golf or softball — can lead to joint wear and tear that ultimately results in a hip labral tear.

A hip labral tear may predispose you to develop osteoarthritis in that joint in the future.

Signs & Symptoms

Many hip labral tears cause no signs or symptoms. Occasionally, however, the patient may experience one or more of the following:

  • A locking, clicking or catching sensation in the hip joint
  • Pain in the hip or groin
  • Stiffness or limited range of motion in the hip joint

Diagnosis

During the physical examination, the doctor will move the leg, and especially the hip joint, around in various positions to check for pain and evaluate the hip’s range of motion. He/she may also want to watch the patient’s walk.

A hip labral tear rarely occurs in isolation. In most cases, other structures within the hip joint have also sustained injuries. X-rays are excellent at visualizing bone. They can check for fractures and for structural abnormalities.

Detailed images of the hip’s soft tissues can be provided through magnetic resonance imaging (MRI). A contrast material may be injected into the hip joint space to better define a labral tear if one exists.

Treatment

Treatment choices will depend on the severity of the symptoms. Some people recover with conservative treatments in a few weeks, while others may require arthroscopic surgery to repair or remove the torn portion of the labrum.

Non-Surgical Treatment

Anesthesia injection
Hip pain can be caused by problems within the joint or outside the joint. The doctor may suggest injecting anesthesia into the joint space. If this relieves the pain, it’s likely that the problem is inside the hip joint.

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

Physical Therapy
A physiotherapist can teach the patient exercises to maximize hip range of motion and hip strength and stability. A physiotherapist can also analyze the movements the patient performs that put stress on the hip joint and help the patient avoid these forces.

Surgical Treatment

If conservative treatments don’t relieve the symptoms, the doctor may recommend arthroscopic surgery — in which a fiber-optic camera and surgical tools are inserted via small incisions in the skin.

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

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