Injuries to the labrum have long been recognized as a possible source of pain and discomfort. Labral injuries in the shoulder are much more common, and the treatment of shoulder labral injuries has been more carefully investigated. With the recent development of arthroscopic techniques to surgically manage the hip joint, there has been increased recognition and awareness of hip labral tears.
How Does a Tear Occur in the Hip Labrum?There are two general types of hip labral tears: degenerative tears and traumatic injuries.
A degenerative tear is a chronic injury that occurs as a result of repetitive use and activity. Degenerative labral tears can be seen in the early stages of hip arthritis.
A traumatic hip labral tear is usually an acute injury as a result of a sports injury, fall, or accident. Hip labral tears can be seen in association with episodes of hip dislocation or subluxation. They are commonly associated with sudden, twisting maneuvers that cause immediate pain in the hip.
What Are the Symptoms of a Hip Labral Tear?A hip labral tear can be difficult to diagnose. Many of the symptoms of a hip labral tear are similar to symptoms of a groin strain, snapping hip syndrome, sports hernia, or other athletic injuries of the hip joint. Furthermore, just because a tear is seen in the hip labrum on an MRI, it does not mean the tear is necessarily the cause of the pain.
Typical symptoms of a hip labral tear include:
- Groin pain
- Clicking and snapping sensations in the hip
- Limited motion of the hip joint
Many doctors will also use a diagnostic injection to help clarify the location of the problem. To perform a diagnostic injection of the hip joint, your doctor will insert a needle into your hip joint while watching on an x-ray monitor to ensure the needle is in the proper position. The hip joint is then injected with a local anesthetic. If the injection completely alleviates the symptoms of pain, it is likely that the cause of the problem was located in the hip joint. If the pain persists, investigation into the cause of the problem should proceed to other possible diagnoses.
Treatment of Hip Labral TearsThe treatment of hip labral tears is evolving quite quickly. Only a few years ago this injury was rarely recognized. Now it is becoming increasingly common to hear of athletes having their "hip scoped" to have their labral tear treated.
In general, the treatment of a hip labral tear usually starts off with some simple steps. Typical early treatments of a hip labral tear include:
The torn labrum in the hip can cause inflammation around the joint. Allowing the inflammation to settle down may alleviate the symptoms of the labral tear and allow return to activities.
- Anti-Inflammatory Medications
Anti-inflammatory medications can be helpful in diminishing some of the inflammation in the joint. If the inflammation subsides, the symptoms may resolve.
- Physical Therapy
Physical therapists can use various techniques to improve hip function by strengthening and balancing the muscles around the hip joint.
- Cortisone Injection
A cortisone injection is useful not only as a treatment of the labral tear, but it can also be performed at the same time as a diagnostic injection the help determine the cause of the hip pain.
Treatment of the labral tear usually consists of shaving out the torn portion of the labrum. In some larger tears, located in an accessible area of the joint, a repair of the labrum may be attempted. Recovery from a hip arthroscopy depends on the extent of work that needs to be completed, but usually lasts 6 to 12 weeks.
Are there downsides to hip arthroscopy?Hip arthroscopy has become very popular recently, but surgeons are just getting to know this procedure and constantly refining their techniques. While the incisions are small, there are potential complications of this procedure that should be considered before treating a labral tear surgically. Hip arthroscopy is relatively new to most surgeons, and while early results have shown this can be a successful treatment, it is still being developed.
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