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