The labrum is the ring of fibrocartilage or soft tissue that surrounds your hip socket (acetabulum). Its purpose is to help the ball part of your hip joint (the femoral head at the top of your femur) move smoothly within the deepened socket and to keep the hip joint stable and working effectively. If you tear your labrum you will often experience hip pain which is made worse by moving, bending or rotating the hip. In some cases, however, you may have a labral tear without experiencing any symptoms.
What causes hip labral tears?
If you sustain a hip injury, you may develop a hip labral tear. These normally occur during high impact sports like rugby, football or ice hockey or sports where you make repetitive movements such as in golf or cycling. However, labral tears are not always caused by a traumatic injury. Certain degenerative conditions like osteoarthritis cause the cartilage to wear away and, as it does so, the labrum becomes degenerate and is more likely to tear. In addition, as we get older, our fibrocartilage tissues (knee meniscus & hip labrum) become stiffer, degenerate and more prone to tear with normal joint use and ageing.
Osteoarthritis is an age-related condition but being overweight can also increase your risk as it puts weight-bearing joints under pressure. If you have a structural abnormality you can also be prone to tearing of the labrum. With femoroacetabular impingement, for example, the femoral head – the ball portion of the joint – does not fit properly into the socket. This prevents the hip from moving properly and causes ongoing groin pain, which may lead to osteoarthritis.
What are the symptoms of a hip labral tear?
Common symptoms associated with a torn labrum are hip pain and pain in the groin or buttocks. Your hip joint may feel stiff and it may click or lock when you move. The pain tends to be worse if you exercise or play sports and certain movements, such as bending or rotating your hip, can exacerbate your symptoms. For some people, however, a torn labrum may be asymptomatic so you may not even realise you have sustained any damage.
How are hip labral tears diagnosed?
If you visit your doctor with hip or groin pain, they will carry out a physical examination and may ask you to make particularly movements or walk around so they can assess how the pain is affecting you. If they suspect a hip labral tear you may be referred for diagnostic testing. An X-ray may be used to determine if you have femoracetabular impingement or osteoarthritis while an MRI scan can show where the labral tear is and how severe it is.
How are hip labral tears treated?
If the labral tear is relatively minor you may be able to manage the symptoms using anti-inflammatories, exercises recommended by a physiotherapist or a steroid injection directly into the hip joint. Unfortunately, a torn labrum won’t heal on its own so if the symptoms worsen or the tear is severe, your doctor may recommend surgery.
Many appropriate hip labral tears can be treated arthroscopically (i.e. using keyhole surgery). The surgeon will make a number of small incisions around the hip and use a camera (arthroscope) and tiny surgical instruments to repair the torn tissues or reconstruct the labrum using healthy tissue taken from elsewhere in your body or from a donor. Sometimes you may need a debridement, which is surgical removal of loose pieces of labral tissue within the joint. If the surgeon discovers femoroacetabular impingement, the surgeon will attempt to correct the problem to reduce the risk of a second labral tear.
How quickly will I recover from surgery for a labral tear?
The prognosis is generally good after surgery for a hip labral tear. Most people recover fully within four to six months and can normally return to most types of sports and physical activity. However, even without surgery, you may be able to manage the condition sufficiently if the tear is small however you may require additional treatment at a later date. If osteoarthritis is the cause of your labral tear, hip arthroscopy is less appropriate as the condition will continue to degenerate with time, so you will need to discuss ways to manage it with your doctor or surgeon.
It is important to see a doctor if you have severe or ongoing hip pain as a proper diagnosis is essential to understand how to treat the condition. If you are concerned about hip pain or believe you may have sustained a hip labral tear, contact us for information about diagnosis and treatment.
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