| Hip Labral
Tear
Definition
The socket of your hip joint (acetabulum) is lined by
cartilage called your labrum. This cartilage provides stability
and cushioning for your hip joint, allowing the ball of your
thighbone (femur) to move smoothly and painlessly in the socket.
A tear in your labrum, known as a hip labral tear or
acetabular labral tear, can result from injury, repetitive
movements that cause wear-and-tear on your hip joint, or
degeneration, such as from osteoarthritis.
In many cases, a hip labral tear causes no signs or symptoms
and doesn't require treatment. Occasionally, however, a hip
labral tear may cause pain or a "catching" sensation in the hip
joint.
When treatment for a hip labral tear is necessary, it may
consist of physical therapy, medications or a combination. Less
frequently, surgery is necessary to treat a hip labral tear.
Symptoms
Many hip labral tears cause no signs or symptoms.
Occasionally, however, you may experience one or more of the
following:
- A locking, clicking or catching sensation in your hip
joint
- Pain in your hip or groin
- Stiffness or limited range of motion in your hip joint
Causes
The cause of a hip labral tear may be:
- Repetitive activities.
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.
- Trauma. Injury to
or dislocation of the hip joint, such as from playing
football, hockey and other contact sports, can cause a hip
labral tear.
- Diseases or conditions that
damage the labrum. These may include degenerative
conditions such as osteoarthritis or femoroacetabular
impingement (FAI), a condition in which the ball of your
femur and your acetabulum rub together abnormally, causing
friction in your hip joint.
Sometimes a hip labral tear has no known cause.
Risk factors
The following factors may increase your risk of a hip labral
tear:
- Overuse. People who
participate in sports or other activities that require
repeated twisting or pivoting motions are more likely to
experience a hip labral tear.
- Conditions that compromise
the labrum. Having a condition such as
osteoarthritis or femoroacetabular impingement (FAI), a
condition in which there's too much friction in your hip
joint, puts you at a greater risk of a hip labral tear.
When to seek medical advice
See your doctor if you experience the signs and symptoms of a
hip labral tear — including a clicking or catching sensation in
your hip, or pain in your hip or groin.
Tests and diagnosis
Your doctor will ask about your symptoms and conduct a
physical examination. He or she may ask you to move your hips
and legs in different positions to assess your range of motion
while asking you about any pain or unusual sensations.
To confirm a diagnosis of a hip labral tear, you may undergo
a special type of magnetic resonance imaging (MRI) called
magnetic resonance (MR) arthrography.
Magnetic resonance (MR) arthrography is a noninvasive
technique that uses a magnetic field and radio waves to create
cross-sectional images of joints. During magnetic resonance (MR)
arthrography, contrast material is injected into the joint space
to help make images more clear.
Treatments and drugs
Many hip labral tears cause no signs or symptoms and need no
treatment. However, when treatment is necessary it may include:
- Physical therapy.
Exercises to maximize hip range of motion and hip strength
and stability can help to improve symptoms. A physical
therapist also can analyze the movements you perform that
put stress on your hip joint and help you avoid these
forces.
- Corticosteroid injections.
A corticosteroid injection into the hip joint can help
provide pain relief and reduce joint inflammation. These
injections are performed under X-ray or ultrasound guidance.
- Pain medications.
Acetaminophen (Tylenol, others) and nonsteroidal
anti-inflammatory drugs (NSAIDs) can provide pain relief.
NSAIDs include such over-the-counter (OTC) medications as
ibuprofen (Advil, Motrin, others) and naproxen (Aleve,
others).
Arthroscopic surgery
If you have a hip labral tear and experience hip pain for more
than four weeks, your doctor may recommend a surgical procedure
called hip arthroscopy.
During hip arthroscopy, an orthopedic surgeon inserts a
flexible, drinking-straw-sized instrument (arthroscope) into
your joint space through a small incision in your skin. The
arthroscope is fitted with a lighting system and tiny camera,
enabling the surgeon to see into your joint.
Once the surgeon can see the joint, the specialized
instruments needed to perform the procedure are inserted through
small accessory incisions. 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 cartilage with a suture procedure.
Prevention
No specific exercises or other steps have been proved to
prevent hip labral tear. However, a program of lower extremity
strength training and core stability exercises may help you
prevent lower extremity injuries in general, including hip
labral tear.
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