Hip Labral Tear Symptoms and Treatment

The hip joint is a "ball and socket" joint. The "ball" part of the joint is the top part of your thigh bone. The "socket" is a part of your pelvic bone. These bones fit together and make up the hip joint. 

The labrum is a ring of soft tissue and cartilage around the edge of the socket. The labrum has several functions: it deepens the socket to improve hip stability, acts as a gasket providing a suction seal for the hip, and contributes to proprioception and coordination of complex hip movements.

A labral tear is when the acetabular labrum in the hip is torn.

What Causes a Hip Labral Tear

• Trauma to the hip like from a sports injury or car accident
• Overuse or repeat motions of the hip
• Arthritis or damage to the cartilage from wear and tear
• Playing sports with a lot of twisting and pivoting like football, ice hockey, soccer, golf or ballet
• Hip dysplasia — when the socket of the joint is not deep enough
• Impingement — when there is bony mismatch between the shape of the ball and socket preventing smooth gliding and interfering with dynamic hip movement

Symptoms of a Labrum Tear

Labral tears are very common and can happen in patients of all ages and activity levels. Because labral tissue becomes less robust and more brittle with time, labral tears become more common as you age. In fact, up to 70% of adults have a labral tear in their hip, though these tears do not always cause pain. Labral tears may be asymptomatic. In addition, if you have a labral tear, it may not always be the cause of your hip pain.

Symptoms of a labral tear include:

• Hip or groin pain, worse with squatting, bending forward and longer periods of standing, walking or running
• Catching, locking, or clicking of the hip
• Stiffness
• Low back or buttock pain

You can still walk with a torn labrum, though you may feel discomfort.

Diagnosing a Labral Tear of the Hip

Our orthopaedic doctors will perform specialized physical exams on your hip to help diagnose the cause of your hip pain. We also have access to the latest imaging equipment and diagnostic techniques to view your hip from different angles and determine the best course of treatment. Your workup may also include:

• X-rays — Taken in specific positions and from special angles. X-rays are extremely important for identifying why a hip labral tear occurred. X-rays may show whether arthritis is present, and also can identify impingement or other structural abnormalities such as dysplasia (shallow hip socket).
• MRI scan  — Though your doctor may suspect a labral tear based on your x-ray and physical exam, the hip labrum is not visible on an x-ray, and an MRI is needed to see whether or not the labrum is torn.
• A numbing injection — In the hip to help identify or confirm the location of your pain. It is important to remember that repairing a labrum that is not painful is not likely to improve your hip symptoms

Hip Labral Tear Treatment 

Asymptomatic labral tears do not need to be treated. 

Though tears will not heal on their own, many patients will find that their symptoms improve with conservative treatment including:

• Rest, ice and activity modification
• Over-the-counter pain medication such as acetaminophen or ibuprofen
• Physical therapy (PT) with a therapist who specializes in the hip
• Injections, such as cortisone

Surgical Treatment

Hip arthroscopy is a minimally invasive surgical procedure used to fix labral tears if conservative treatment options fail to improve your symptoms. 

The surgery three is completed using several small incisions that allow us to look inside your hip joint with a camera and special instruments. We first do an overall inspection of the joint to look for evidence of cartilage damage and to assess the overall health of the joint and surrounding structures. 

In most cases, we can repair the labrum with special sutures. We will also shave down any extra bone on the ball or the socket (impingement) that may have contributed to the labral tear. This protects the repair and helps prevent it from happening again. Sometimes the labrum is too damaged to be repaired, and instead we may need to trim out the torn tissue. In some special circumstances, we may even use a tissue graft to reconstruct a new labrum.

The total recovery time after hip arthroscopy is approximately four to six months.