Labral tears of the hip is a diagnosis that is more frequently encountered in both recreational and professional athletes. This athletic injury is especially common in athletes who perform repeated hip flexion such as runners, hockey players, soccer players, and football players. Labral tears may occur in isolation, or may be the result of early arthritis of the hip.
What is the Labrum
The hip joint is a ball and socket type joint, with the femoral head (ball) located within the acetabulum (socket). There is a covering of articular cartilage on both surfaces, which allows the hip to glide smoothly in any direction.
The labrum is a rim the runs around the outside of the acetabulum (socket), and functions as a suction seal for the femoral head. When the labrum gets torn, it can get pinched between the femoral head and acetabulum, causing pain with flexion and rotation of the hip.
The diagnosis of labral tears of the hip is based on a patients’ history, physical exam, and imaging studies.
Patients with labral tears often have a long history of vague groin pain, accentuated by sharp pains with certain movements (especially hip flexion and rotation). Patients may have a history of chronic groin strains as well.
A typical physical exam of a patient with a labral tear shows good overall range of motion, but pain with flexion and internal rotation of the hip.
Radiographs will often show an abnormal bump on the femoral head, and an MRI is often useful in the diagnosis of a labral tear.
This MRI demonstrates a hip with a labral tear (white arrow).
The initial treatment of labral tears is usually with rest, anti-inflammatories, and physical therapy, as many labral tears become asymptomatic over time. Physical therapy is quite beneficial in many patients to improve hip range of motion, strengthen “Core” muscles, and decrease pain associated with a labral tear.
Anti-inflammatories are also very helpful in decreasing the inflammation and pain associated with a labral tear.
In patients that continue to have pain despite physical therapy, arthroscopic surgery can be beneficial in treating the labral tear. Hip arthroscopy utilizes small incisions and specialized instruments to remove the damaged part of the labrum. Patients who undergo hip arthroscopy are usually on crutches for between two and six weeks depending on the exact surgical procedure. Physical therapy is a key part of the recovery and is used to regain strength and motion about the hip.