Labral tear of the hip

Description

A tear in the labrum of the hip involves the ring of cartilage (labrum) that follows the outside rim of your hip joint socket. In addition to cushioning the hip joint, the surgeon acts like a rubber seal or gasket to help hold the ball at the top of the thighbone securely within your hip socket.

Athletes who participate in sports such as ice hockey, soccer, football, golf and ballet are at higher risk of developing labral hip tears. The structural problems of the hip also can lead to a tear in the labrum of the hip.

Symptoms

Many labral hip tears do not cause any signs or symptoms. However, some people have one or more of the following:

  • Pain in the hip or the groin, often exacerbated by long periods of standing, sitting or walking or in sports activity
  • A locking, clicking or catching sensation in the hip joint
  • The stiffness or limited range of motion in the hip joint

When to see a doctor

Seek medical attention if symptoms worsen or do not improve within a period of six weeks.

Causes

The cause of a tear in the labrum of the hip can be:

  • The Trauma. Injury or dislocation of the hip joint that can occur during car accidents or contact sports such as football or hockey — can cause a tear in the labrum of the hip.
  • Structural problems.Some people are born with hip problems that may accelerate the wear and tear of the joint and, eventually, cause a tear in the labrum of the hip. This may include having a socket that does not fully cover the ball portion of the upper part of the thigh bone (dysplasia) or a socket bit, which may put more pressure on the labrum. Extra bone in the hip, called impingement femoroacetabular (FAI), also can cause compression of the labrum, which can lead to breakage over time.
  • Repetitive movements. Related to sports and other physical activities — including the long-distance races and the sudden twisting or pivoting motions common in the golf or softball can lead to joint wear and tear that ultimately the result of a tear in the labrum of the hip.

Structural problems. Some people are born with hip problems that may accelerate the wear and tear of the joint and, eventually, cause a tear in the labrum of the hip. This may include having a socket that does not fully cover the ball portion of the upper part of the thigh bone (dysplasia) or a socket bit, which may put more pressure on the labrum.

Extra bone in the hip, called impingement femoroacetabular (FAI), also can cause compression of the labrum, which can lead to breakage over time.

Risk factors

Any person can get a tear in the labrum of the hip, but certain conditions and activities that increase the risk.

People with structural problems in the hip, such as shock, dysplasia, or loose ligaments are more prone to develop a tear in the labrum of the hip over time.

To participate in certain activities that involve repetitive or twisted can increase the risk of developing a tear in the labrum of the hip. These are sports such as ballet, golf and swimming. Contact sports such as football and hockey also increase the risk of injury of the hip, including labral hip tears.

Complications

A tear in the labrum of the hip may make it more likely that you will develop osteoarthritis in the joint.

Prevention

If the sports you play put a lot of pressure on their hips, condition of the surrounding muscles with strength and flexibility exercises.

Labral tear of the hip

Diagnosis

Your doctor will take a history of your discomfort. The physical examination is likely to involve moving your leg, and especially of the hip joint, in various positions to check for pain and evaluate the hip's range of motion. He or she also can be seen walking.

Imaging scans

A tear in the labrum of the hip is rarely occurs by itself. In the majority of cases, other structures within the hip joint also have injuries. X-rays are excellent for the display of the bones. You can check for arthritis and structural problems.

A magnetic resonance arthrography (MRA) can provide detailed images of your hip to the soft tissues. the magnetic resonance angiography (MRA) combines the technology of magnetic resonance imaging with a contrast material is injected into the hip joint space to make a tear in the labrum easier to see.

Injection of anesthesia

Hip pain can be caused by problems inside the joint or outside the joint. Your health care provider may suggest that the injection of an anesthetic into the joint space. If this relieves the pain, it is likely that your problem is in the interior of the hip joint.

Treatment

The treatment depends on the severity of the symptoms. Some people recover within a few weeks with conservative treatments, such as rest and modification of activities; others require arthroscopic surgery to repair the torn part of the labrum.

Drugs

Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), can relieve the pain and reduce inflammation. The pain can also be controlled temporarily with an injection of corticosteroids into the joint.

Therapy

A physical therapist can teach you exercises to increase hip range of motion and the accumulation of the hip and core strength and stability. Therapists can also teach you to avoid movements that cause stress in the hip joint.

Surgical and other procedures

If the conservative treatments do not relieve your symptoms, your doctor may recommend arthroscopic surgery in which a fiber-optic camera and surgical instruments are inserted through small incisions in the skin.

Depending on the cause and extent of the fracture, the surgeon can remove the broken piece of labrum or repair the torn tissue by sewing it back together.

Complications of surgery can include infection, bleeding, nerve injury, recurrent symptoms, and if the repair does not cure correctly. A return to sports usually takes 3 to 6 months.

Preparing for your appointment

Your health care provider may refer you to a doctor who specializes in disorders of the hip or sports medicine.

What you can do

Make a list that includes:

  • Detailed descriptions of your symptoms and when they began
  • Other medical problems that I have had
  • Activities that could contribute to your hip pain
  • All the drugs, vitamins, and other dietary supplements that you are taking, including dose
  • Questions to ask the doctor

What to expect from your doctor

Your health care provider might ask:

  • Where is the pain?
  • What it was doing when it started?
  • Is there anything that the pain better or worse?
Symptoms and treatment of labral tear of the Hip