Labral Tears of the HIP

The hip joint has a cartilage ring around the socket portion of the ball and socket of the joint called the labrum. The labrum adds to the stability of the hip joint by making the socket deeper, however labral tissue in the hip can be torn from either repeated wear and tear or from a sudden injury or trauma.

A tear in the labrum of the hip causes pain in the joint and/or into the groin.  It can also cause a popping or catching sensation deep in the joint.  A forceful twisting injury or a traumatic hip dislocation can cause labral tears but usually hip labral tears are caused by a slow progressing chronic injury that is caused by the shape of the ball of the hip joint’s ball and socket not completely matching the concavity of the hip socket.  Certain athletes are more prone to hip labral tears such as golfers due to the twisting motion of the hips with a drive, or ballet and other dancers due to the extreme range of motion that the hip joint is put through with extremely high kicks and leaps.  In addition to a physical exam the final diagnosis needs to be done with an MRI of the hip joint.

Treatment- Although conservative treatment such as injections or physical therapy can be tried first a labral tear of the hip is usually requires surgery since the labrum does not have a good blood supply.  In surgery the tear can be either repaired or debrided (trimmed/cleaned up) arthroscopically, often referred to as a hip scope.  With a labral repair the torn area is repaired with stitches.  In a debridement the tear is trimmed away and the torn parts removed.  During a hip scope the surface of the socket is often times smoothed out during the surgery so that the joint fits together better mechanically and the risk of future tears is reduced.

At Elite Sports Medicine and Orthopaedic and Orthopaedic Center our physicians and staff are dedicated to providing the best orthopaedic care in the region, including care for a hip labral tear.  Call 615-324-1600 for an appointment.

– Karen Tate, PT

What is a Labral Tear of the Hip?

The hip joint is a ball and socket joint.  The labrum is the cartilage ring around the socket. The labrum adds to the stability of the hip joint by making the socket deeper and providing a suction seal to the joint.  The labrum can be torn from either repeated wear and tear or from a sudden injury or trauma.

A tear in the labrum of the hip can cause symptoms of pain, popping, or catching.  The pain is usually in the groin but can also radiate down the upper leg or side of the leg.  The mechanism of injury is often not known by the patient.  Causes of a tear can be from a twisting injury, a traumatic dislocation, or repetitive overuse.  Some patients have abnormal bone shape that can pinch the labrum causing a tear.  This pathology is known as hip impingement.  Sometimes the labrum is injured from repetitive or extreme motions that happen during sports.   Certain athletes are more prone to hip labral tears.  Sportssuch as golf that involve a twisting motion of the hip can lead to labral tears.  Ballet dancing and martial arts can put the hip in extreme motions that can also tear the labrum. 

To determine if someone has a labral tear, a physical exam is performed in the doctor’s office.  In addition to a physical exam, an MRI scan is often helpful in confirming the diagnosis. 

Some patients will elect for conservative treatment such as injections or physical therapy.  These treatments can often help decrease the symptoms of a labral tear.  When conservative method are not successful in getting patients out of pain, surgery is often their choice.  Arthroscopic surgery is successful in repairing the labrum and correcting any bony impingement.   The labrum is usually repaired with anchors which are stitches that hold torn labrum back to the bone of the socket.  Sometimes the labrum cannot be repaired and is debrided or trimmed away until the remaining tissue is stable.  If there is an abnormality in the bone seen on an x-ray, a CT scan is often done to create a 3-dimentional model of the hip joint.  With this information, the surgeon can smooth out the abnormal bone to reduce the risk of future tears. 

At Elite Sports Medicine and Orthopaedic Center our physicians and staff are dedicated to providing the best orthopaedic care in the region, including care for a hip labral tear.  Call 615-324-1600 for an appointment. 

Article by Chad Price MD