The labrum is a piece of cartilage that lines and reinforces a ball-and-socket joint, like the hip joint. The diagram to the right illustrates how the labrum can tear away from the acetabulum (the socket of the hip bone, where the femur attaches). When this cartilage tears, it can get pinched in the joint or disconnect entirely and become a loose body within the joint.
The hip is a ball-and-socket-joint: the femoral head forms the ball and the acetabulum, which is part of the pelvic bone, forms the socket. The labrum of the hip is a cuff of thick fibrocartilage tissue that surrounds the acetabulum. The labrum helps to support the hip joint and provide stability.
A labral tear occurs when a piece of the labrum cartilage becomes pinched between the femoral head and the acetabulum causing pain and catching sensations. Hip labral tears can result from either degeneration (wear-and-tear) or anatomical abnormalities. Hip labral tears usually affect active adults between the ages of 20 to 40.
- Degeneration: degenerative tears occur with repetitive stress, such as repetitive pivoting and hip flexion.
- Anatomical abnormalities: the most common anatomical abnormality to cause hip labral tears is called Femoral Acetabular Impingement (FAI – for more information please visit the FAI section of this page). The extra boney structure that defines FAI reduces the amount of space within the joint, pinching the labrum between the acetabulum and femoral head.
Labral tears are commonly seen in athletes who play contact sports such as football, basketball, field hockey, and soccer.
Symptoms:
- Loss of range of motion
- Inability/weakness when moving leg across the body
- Inability/weakness when lifting leg
- Pain in the groin area
- Pinching feeling deep within the joint
- Catching/snapping sensation with specific motions
- ‘C’ sign pain – pain in the cross section of the front and outer side of the thigh
- Sensation of instability/looseness
- Pain with:
- Getting into and out of the car
- Going from a sitting to stand position
- Sleeping on the affected side
- Twisting and turning
- Crossing legs while sitting
- Daily activity
If your symptoms last longer than 2 weeks and interfere with daily activity, you should consult your primary care physician for a referral.
What To Expect During Your Appointment:
During your appointment your Dr. Betz will perform a physical exam to test your hip’s range of motion and leg strength. In-office imaging may be done or an MRI may be set up to diagnose the cause of your pain. A specific type of MRI called an arthrogram is used to diagnose labral tears. During the arthrogram, the radiologist will inject contrast dye into your hip joint, making it easier to find small abnormalities within the joint. Once the results of your imaging come back, Dr. Betz will provide treatment options and help you decide the course of action that is best for you.
Treatment
Dr. Betz performs an in-office exam on the patient to check for a labral tear.
Non-Surgical Options:
- Rest
- Medication: non-steroidal anti-inflammatories are often prescribed to minimize swelling and pain.
- Physical Therapy: strengthening the upper leg will help relieve pain and prevent further injury. Stretching is also performed to help regain mobility.
- Injections: If the other non-surgical treatments fail, Dr. Betz can use injections to help reduce pain.
- Steroid Injection (Cortisone): steroids are proven to be very effective at reducing inflammation and pain when injected directly into the joint space.
- Platelet Rich Plasma (PRP): your own blood is used to extract platelet-rich plasma, which is then injected into your hip joint. The platelets within the plasma stimulate the body to repair itself.
Surgical Options:
If non-surgical treatment methods fail to improve pain, Dr. Betz will discuss surgery as an option. Each patient and tear is different, but most tears can be treated arthroscopically. For more information on arthroscopic surgery please see “Arthroscopic Surgery”.
For postoperative patients: