Hip Labral Tear

The labrum is a ring of fibrocartilage that extends around the socket of the hip joint. The labrum serves many functions performs many functions including acting as a shock absorber, lubricating the joint, and distributing pressures within the hip joint equally. It centers the femoral head in the socket and prevents lateral and vertical movement of the femoral head within the joint. It also deepens the acetabular cavity and offers stability against femoral head translation.

Causes of labral tear include:

• Trauma
• Femoroacetabular Impingement (FAI)
• Hip hypermobility
• Hip dysplasia
• Degenerative changes in the hip
• Sports injuries – commonly in ice hockey, soccer, ballet, and golf

Patients with labral tears present with pain due to nerve endings present in the labrum that can stimulate pain fibers, causing pain sensation in the hip region. Patients may also present with clicking or locking of the joint and restricted hip motion. Patients may also experience dull pain on movement that does not subside with rest. Hip labral tears are often diagnosed with detailed history of the patients clinical symptoms, physical examination findings, and radiographic studies. Magnetic resonance arthrography (MRA) is a useful imaging study for diagnosing labral tears.

Initially, conservative treatment consisting of rest, anti-inflammatory medication, and physicaly therapy is started. These methods may offer symptomatic relief, however, surgery is usually required to repair the underlying torn labrum. Surgery is usually performed via arthroscopic technique using poke-hole incisions to introduce an arthroscopic camera and instruments. If repairable, the labrum is stabilized using anchors and suture. If there is a small flap, the labrum may be shaved until it is smooth, or debrided. If the labrum is severely torn, it may be reconstructed with a cadaver tendon.