Description

A hip labral tear is an injury to the labrum, the soft tissue that covers the acetabulum (socket) of the hip. The role of the labrum is to support and hold the head of the femur inside the acetabulum.

A hip labral tear can be caused by injury, structural problems, or degenerative issues. Symptoms include pain in the hip or stiffness.

Causes

Hip labral tears can be caused by many things, including the following:

• Structural ailments: Conditions that cause abnormal hip movement can also lead to hip labral tears. In femoroacetabular impingement (FAI), the femoral head doesn’t fit into the socket properly. This imperfect fit can cause long-lasting groin pain and movement limitations. This is the most common cause of labral tears. Without treatment, it can result in osteoarthritis in some patients.
• Injury: Trauma to the hip can lead to a hip labral tear. This can happen to people who play certain sports that have repetitive and high-impact movements, such as ice hockey, football, soccer and golf. This can also be caused by high velocity motor vehicle accidents.
• Degenerative health conditions: Osteoarthritis is a chronic (long-term) wearing down of the cartilage between the joints. As cartilage slowly erodes over time, it becomes more prone to tearing. Older age and excessive weight can increase a person’s risk for developing osteoarthritis. People with osteoarthritis commonly have pain and stiffness in more than one joint (the hip and knee, for example).

Symptoms

The symptoms of a hip labral tear include:

• Hip pain or stiffness
• Pain in the groin or buttocks area
• A clicking or locking sound in the hip area when you move
• Feeling unsteady on your feet

If you have a hip labral tear, hip pain or discomfort may get worse when you bend, move or rotate the hip, or exercise or play sports. It’s also possible to have a hip labral tear with no symptoms at all.

Treatment

Non-Surgical Management

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 (Motrin®, Advil®) can reduce inflammation.
• Physical therapy: Specific physical therapy exercises to stretch and strengthen the hip muscles may help relieve pain. Physical therapy usually requires a prescription from your doctor.

Injection may be beneficial for this condition. They may include:

• Cortisone (Corticosteroid)
• Platelet Rich Plasma (PRP)
• Prolotherapy
• Botox
• Trigger Point Injections

Surgical Treatments

If symptoms persist or if the tear is severe, your doctor may recommend surgery. Surgery to repair a hip labral tear is usually done with arthroscope. This is a minimally invasive surgery in which the doctor makes small incisions (cuts) in the hip and uses miniature instruments to make the following repairs with the help of a small camera. The possible surgical options include:

• Refixation or repair (stitching the torn tissue back together)
• Reconstruction (reconfiguring damaged tissue using healthy tissue from elsewhere on your body or from a donor)
• Debridement (removing a small piece of labral tissue)

If FAI is also present, it will be addressed (removed) at the same time to help prevent the labrum from tearing again.
The arthroscopic surgery is often done on an outpatient basis, meaning the patient goes home the same day.