Labral Tears in the Hip

FAQs on Labral Tears in the Hip

 

Labral tears in the hip are a source of discomfort, pain, and potential osteoarthritis in the hip joint. About a fifth of all athletes with groin pain suffer from hip labral tears. There are many treatment methods available to treat these injuries to the acetabular labrum surrounding the hip socket. Arthroscopic techniques make the surgical option more convenient while new methods, such as prolotherapy, helps in regenerative curative treatment.

What is labral tear in the hip?

Labral tears in the hip refer to damage to the acetabular labrum, a dense fibrocartilagenous connective tissue within the hip joint bordering the acetabulum or the ball-and-socket joint in the hip. The labrum seals the hip joint, disseminate stress on it, and provide added cushion and stability to the acetabulum during activities.

Hip labral tears surface when a part of the acetabular labrum is damaged partially or completely or subject to compression or traction injuries. There two most common types of labral tears in the hip.

  • Degenerative tear linked to labral wear and tear
  • Traumatic hip tear traced to injury to the labrum

What is the acetabular labrum and what is its role?

Labrum is a ring of fibrous cartilage that covers the surface of a bone at a joint. In the hip joint, the acetabular labrum is a crescent-shaped cartilage running along the edge of the socket. A connective tissue surrounding the bony socket, its primary role is to seal the hip joint and provide it added cushion and stability. It is also known as the cotyloid ligament.

One side of the labrum is connected to the joint capsule and the other touches the femoral head. By sealing the joint, it ensures the proper fluid level inside the joint that keeps the cartilage healthy and free from degenerative arthritis.

What are the symptoms of labral tears in the hip?

  • Pain in the hip front
  • Hip stiffness
  • Groin pain
  • Restricted hip joint movement
  • Clicking, locking, or catching feeling in the hip joint
  • Pain radiate to buttocks
  • Worsening pain with twisting or weightlifting or climbing stairs or squatting
  • Limited ability to participate in sports or dancing
  • Microinstability of the hip

What causes labral tears in the hip?

In 75% cases, there is no definite cause to blame for labral tears in the hip. These injuries are caused by number of factors, such as

  • the labrum subject to recurring excessive force, pressure, or stress
  • hip dislocation, degeneration, or dysplasia
  • repetitive microtrauma impacting the hip and the capsular tissue
  • hypermobility of the hip joint capsule
  • compression or traction injuries to the labrum
  • stiffness in the iliopsoas tendon
  • wear and tear of the labrum with age
  • hip rotational instability
  • excessive weight or stress on the labrum or the femur during sports activities
  • damage to iliofemoral ligament
  • fall on the hip leading to blunt force on the joint
  • impingent of the labrum
  • hip structural abnormalities
  • hip muscle tightness or weakness

Who are at the risk of labral tears in the hip?

Older people and those participating in sports activities are at the risk of causing hip labral tears.

How is labral tear in the hip diagnosed?

Doctors examine symptoms for potential labral tears in the hip by moving your hip joint and the leg in different postures and directions. The range of motions your hip is comfortable to perform indicate its condition. X-ray helps to examine if other bony structures in the joint are injured or have structural abnormalities. MRI helps to check injury to soft tissues around.

What are the treatment methods available for labral tear in the hip?

  • Medication: Anti-inflammatory medicines reduce inflammation and it helps resolve symptoms.
  • Anesthetic injection: Lidocaine directly inserted into the joint reduces inflammation and pain assisting in faster healing.
  • Cortisone injection: The steroid injection provides semi-permanent relief inhibiting inflammation and pain.
  • Physical Therapy: This includes a broad range of self-care and assisted care options, such as Ice, rest, acupuncture, workouts, massage therapy, use of strap, and a variety of other techniques to reduce stress on the hip joint, improve hip strength and stability, and maximize hip joint functions.
  • Surgical Intervention:
  • Arthroscopic surgery to reattach and repair the torn labrum
  • Debridement surgery to remove the dead tissues
  • Prolotherapy: Regenerative stem cell and PRP injections are found to be 54% effective in treating labral tears in the hip completely. Based on regeneration the damaged tissues, the therapy has been found to be beneficial for a variety of pain associated with the hip joint.

References

HA Ross, O Amos. Regenerative Injection Therapy (Prolotherapy) for Hip Labrum Lesions: Rationale and Retrospective Study. The Open Rehabilitation Journal, 2013, 6, 59-68 59

Krych AJ, Griffith TB, Hudgens JL, et al. Limited therapeutic benefits of intra-articular cortisone injection for patients with femoro-acetabular impingement and labral tear. Knee Surg Sports Traumatol Arthrosc. 2014 Apr;22(4):750-5. doi: 10.1007/s00167-014-2862-3. Epub 2014 Feb 1.

Groh MM, Herrara J. A comprehensive review of hip labral tears. Curr Rev Musculoskelet Med. 2009 June; 2(2): 105–117.

Bharam S “Labral tears, extra-articular injuries, and hip arthroscopy in the athlete” Clin Sports Med. 2006 Apr;25(2):279-92.

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Narvani AA, Tsiridis E, Kendall S, Chaudhuri R, Thomas P. A preliminary report on prevalence of acetabular labrum tears in sports patients with groin pain. Knee Surg Sports Traumatol Arthrosc. 2003; 11:403-408McCarthy JC “The diagnosis and treatment of labral and chondral injuries” Instr Course Lect. 2004;53:573-7.

Fitzgerald RH. Acetabular labrum tears. Diagnosis and treatment. Clin Orthop Relat Res. 1995; (311):60-68

Blankenbaker DG, De Smet AA, Keene JS, et al. Classification and localization of acetabular labral tears. Skeletal Radiol. 2007; 36(5):391-397

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