Hip Labral Tear

What is a hip labral tear?

On the outside rim of your hip joint socket, there is a ring of cartilage called the labrum. Its purpose is to cushion the hip joint and to help hold the ball shaped end of your thighbone in place within the hip socket. The labrum can become torn during sports activities or if you have a structural abnormality in your hip.

Common signs and symptoms of a hip labral tear

Often, hip labral tears are symptomless, but sometimes they can cause:

  • Groin or hip pain
  • A feeling of the hip locking, clicking or catching
  • Reduced movement and stiffness in the joint
  • A feeling of unsteadiness when walking

Common causes of a hip labral tear

Hip labral tears are usually caused by:

  • Trauma. Dislocation or injury can occur when playing sports, especially, ballet, golf, football or hockey. Trauma may also occur during events such as car accidents.
  • Abnormalities in the joint. An abnormality in the structure of the joint can cause excessive wear and tear, leading to damage to the labrum.
  • Repetitive movements. Certain repetitive movements such as pivoting and twisting can cause wear and tear over time, resulting in a labral tear.
  • Degenerative conditions. Chronic conditions such as osteoarthritis (wearing down of cartilage in the joints) can make the labrum prone to tearing.

Diagnosing a hip labral tear

To reach a diagnosis, your doctor will assess the condition of your hip by moving your leg into various positions and reviewing how much movement and pain you have. They may also need to watch you walking.

Imaging tests

Your doctor may wish to send you for an imaging scan to help look at your hip in detail. You may be asked to go for either or both of the following types of scan:

  • X-ray – to detect fractures and structural abnormalities
  • MRI scan – to look at soft tissue damage in more detail. You may need to have an injection of a contrast material into the joint. This will help to identify the tear if you have one

Anaesthetic injection

To determine whether your hip pain relates to the area inside or outside of the joint, your doctor may suggest an injection of anaesthetic. If this stops your pain, it will indicate that the pain is likely coming from inside your hip joint.

Treating a hip labral tear

Hip labral tears can vary in severity and your doctor will decide on the best course of treatment based on the symptoms and exact diagnosis. Conservative treatment may be available, or you may require surgery.

Medication

Your doctor may suggest you try medication to relieve your hip pain. Options may include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Brufen (ibuprofen)
  • An injection of corticosteroids into the joint to provide temporary relief

Therapy

Physiotherapy may be recommended to help improve your strength, movement and stability. Your therapist may also be able to tell you what kinds of movements are contributing to the problem so that you can avoid them.

Surgery

Surgery is an option when conservative treatment isn’t appropriate or hasn’t helped. An arthroscopic (keyhole) procedure may be required to repair or remove the torn tissue in the hip joint. In rare cases, you may need to have open surgery where a larger incision is made.

Recovering after a hip labral tear

Your recovery may differ depending on the extent of your tear and the treatment undertaken. For minor tears requiring conservative treatment, it is possible that you may recover in a few weeks as long as you have followed the advice given by your doctor and physiotherapist.

If you have had arthroscopic surgery, you may need to use crutches for 2 to 4 weeks. If you have had open surgery, you may need to use crutches for up to 6 weeks. It is advisable that after surgery, you take 1 to 2 weeks off work. People who do labour intensive work or work that involves long periods of standing may need to take up to 6 months off.

On your doctor’s advice, you may be able to return to light exercise 3 months after arthroscopic surgery or more intense sports after 6 months.

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