The labrum is a rim of cartilage that surrounds the hip joint. The labrum has two sides: one side attaches to the head of the thighbone (femur), the other side attaches to the hip socket (acetabulum). The labrum acts as a rubber seal, or gasket, that helps hold the thighbone securely within the hip socket. It also allows the body to maintain appropriate fluid pressure inside the joint. In addition, the labrum aides in shock absorption, joint lubrication, and stability.
Causes of a Labral Tear
Damage to the labrum can occur due to trauma (running, twisting, slipping), hip impingement (FAI) due to abnormal bone structure of the hip joint, capsular laxity (loose ligaments), hip hypermobility (movement beyond normal range of motion), dysplasia (shallow hip pocket), and degeneration (arthritis).
Symptoms
Most people with labral tears usually experience deep groin pain accompanied by joint stiffness and instability. Patients often experience mechanical symptoms including clicking, locking, and giving way, especially when standing or sitting. Patient history and physical examination are the first tools used to diagnose labral tears in the hip.
Physical Examination
The most consistent finding for a torn labral is a positive anterior hip impingement test. For this test, your doctor will bring your knee up towards your chest and rotate it inward towards your opposite shoulder. If the physician is able to recreate your hip pain, the test result is positive for impingement.
Imaging Tests
Your physician may order imaging tests to help further diagnosis the cause of your hip pain.
X-Rays provide your physician with good images of the hip joint to help diagnose orthopaedic issues.
Magnetic Resonance Imaging (MRI) studies are used to take images of soft tissue and help your physician locate any damage to the labrum. Your physician may also inject dye, or contrast, into the hip joint to show damage more clearly. This is referred to as an MRI arthrogram.
Treatment Options
Conservative, nonsurgical treatment options can be used to address the symptoms of a labrum tear. Changes in activity level may be recommended in order to avoid activities that cause symptoms. Medications can help ease any inflammation and reduce pain. Physical therapy can improve range of motion in your hip and strengthen the muscles that support the hip joint.
Surgical Intervention
Most labral tears can be repaired with arthroscopic surgery.
- Debridement: torn or weakened portions of the labrum are removed. This prevents torn fragments from getting caught in the hip joint, which causes pain and further damages the hip joint.
- Labral Refixation: surgical technique where the labral tissue is repaired using sutures. The surgeon will trim the torn and frayed tissue from the acetabular rim and reattach the torn labrum to the bone of the acetabular rim.
Recovery Time
Recovery time for a labral tear is approximately 3 to 4 months depending on your overall health and the success of your rehabilitation. Physical therapy will be part of the recovery process to help patients regain range of motion and strength in the hip.