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Hip Labral Tears

  • Definition

    A hip labral tear is an injury to the soft elastic tissue around the hip joint called the labrum. The hip joint is made of a ball and socket. The ball is the end of the thigh bone, also called the femur. This ball fits into the bowl-shaped socket in the pelvic bone, also called the acetabulum. Cartilage lines the socket to keep movement smooth and the joint cushioned. The labrum helps to hold the ball of your femur in place. When the this tears, it is called a hip labral tear.
    Hip Joint and Cartilage
    Hip cartilage
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    If you suspect you have this condition, contact your doctor right away.
  • Causes

    Hip labral tears can result from wear and tear or from an injury.
    • Risk Factors

      Factors that can increase your chances of getting a hip labral tear include:
      • Wear and tear of hip joint from different activities, such as golf or softball
      • Traumatic injury to hip
      • Twisting injuries
      • Motor vehicle accident
      • Degenerative diseases like osteoarthritis
      • Femoroacetabular impingement syndrome (FAI)
      • Legg-Calve-Perthes disease
      • Hip dysplasia
      • Osteoarthritis
      • Slipped capital epiphysis
      • Capsular laxity/hip hypermobility
    • Symptoms

      Symptoms vary and can be mild, including:
      • Hip pain: sharp, deep, disabling
      • Locking or clicking of hip
      • Hip instability
      • Limited range of motion
      • Tenderness to touch
      • Groin, buttock, or thigh pain
      • Pain during activity
    • Diagnosis

      Your doctor will ask about your symptoms and medical history. A physical exam will be done. You will likely be referred to a specialist. An orthopedic surgeon focuses on bones and joints.
      Images may need to be taken of your hip. This can be done with:
      An anesthetic may be injected to help diagnose this condition. If the pain gets better with the injection, the problem is in the joint which could be a labral tear.
    • Treatment

      Talk with your doctor about the best plan for you. Treatment options include the following:
      Medical Treatment
      Common medical treatment may include:
      Common medical treatment may include:
      • Nonsteroidal anti-inflammatory drugs (NSAIDs)
      • Steroid injection to the joint
      • Modified activity
      • Physical therapy to strengthen muscles
      Generally, this treatment is tried for several weeks. If there is no improvement, then surgery is considered.
      Surgical Treatment
      Arthroscopy uses a thin, lighted tube inserted through a small incision to view the injury and fix it. Small instruments are threaded through this tube. The torn labrum may be removed or sewn together.
      Arthroscopy uses a thin, lighted tube inserted through a small incision to view the injury and fix it. Small instruments are threaded through this tube. The torn labrum may be removed or sewn together.
      Rehabilitation
      After surgery, you may be fitted with a brace. This will provide support and aid healing. A therapist will work with you. The therapy will include strength exercises and a plan to increase your weight bearing.
    • Prevention

      There are no known guidelines to prevent a hip labral tear.
    • RESOURCES

      American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

      Arthroscopy Association of North America http://www.aana.org

      CANADIAN RESOURCES

      Canadian Orthopaedic Association http://www.coa-aco.org

      Canadian Orthopaedic Foundation http://www.canorth.org

      References

      Bharam S, Philippon MJ. Diagnosis and management of acetabular labral tears in the athlete. International SportMed Journal. 2008;9(1):1-11.

      Burnett SJ, Della Rocca GJ, et al. Clinical presentation of patients with tears of the acetabular labrum. The Journal of Bone & Joint Surgery. 2006;88:1448-1457.

      Hip Labral Tears. Arthorscopy Association of North America website. Available at: https://www.aana.org/VideoEducationLibrary/Articles/HipLabralTears/tabid/130/Default.aspx. Accessed May 6, 2013.

      Hunt DH, Clohisy J, et al. Acetabular Labral Tears of the Hip in Women. Physical Medicine and Rehabilitation Clinics of North America - Volume 18, Issue 3 (August 2007).

      O'Kane J. Anterior hip pain. Am Fam Physician. 1999 Oct 15;60(6):1687-1696. Available at: http://www.aafp.org/afp/991015ap/1687.html. Accessed May 6, 2013.

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