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. The ball fits into a groove called the acetabulum. These bones fit together and are called the hip joint. 

Around the socket, there is a ring of soft tissue or cartilage. It is a smooth tissue that covers the bones inside of the hip joint. Cartilage lets the hip joint glide easily. The hip joint cartilage is the acetabular labrum. The labrum helps to make the socket deeper so the ball of the hip stays in place.

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 crash 
• Overuse or repeat motions of the hip
• Arthritis or damage to the cartilage from overuse or an injury
• 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 the ball portion of the hip is misshaped and does not fit properly in the socket
• Slipped capital femoral epiphysis — in children, the ball of the hip can slip backwards
• Legg-Calve-Perthes disease — where blood flow to the hip is disrupted

Symptoms of a Labrum Tear

Some people don't experience symptoms and don't even know they have a labral tear of the hip. For others, there can be a great deal of discomfort, including:

• Hip or groin pain, worse with squatting or bending forward
• 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 specialists have access to the latest imaging equipment and diagnostic techniques to view your hip from different angles and determine the best course of treatment.

• X-ray
• Specialized hip focused physical exam by an orthopedic provider
• MRI scan
• A numbing injection into the hip to be sure the problem is inside the hip joint and not the surrounding tissues and structures

Hip Labral Tear Treatment 

Some people have labral tears that do not cause any pain. When there is no pain or symptoms from the tear, it is not treated. The torn labrum will not go away on its own. 

When there are symptoms from the tear, some of the nonsurgical treatment options may include:

• Rest, ice and activity modification
• Over-the-counter pain medication such as acetaminophen or ibuprofen
• Physical therapy (PT)
• Hip arthroscopy (surgery)

Surgical Treatment

Hip arthroscopy is a minimally invasive surgical procedure used to fix the torn labrum when conservative treatment options fail to improve your symptoms. 

The surgery uses three small, 1cm 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 along the neck of the femur that may have contributed to the tear. This prevents the tear from happening again. We use special sutures to repair the lining or your hip joint, and three black sutures to close your skin.

The recovery time after hip arthoroscopy is approximately three to six months. 

Risks of Not Treating a Torn Labrum in the Hip

If you continue to have hip pain that does not improve with nonsurgical treatment, you may develop arthritis. When arthritis is bad enough, fixing the labral tear may not be an option. The worse the arthritis, the less successful a hip arthroscopy is. As arthritis progresses you may develop worse pain. If the pain is bad enough, some patients have a cortisone injection into the hip joint. Cortisone injections into the hip joint can provide temporary pain relief. If the pain is severe, interferes with daily activities, and nonsurgical treatment options have failed some patients may choose to have a hip replacement to take care of their pain.

Preventing a Hip Labral Tear

• Stay active and work out to keep your muscles strong and flexible.
• Warm up slowly and stretch before you work out.
• Listen to your body. Do not ignore pain that stays after your workouts.
• Use good ways to train, such as slowly increasing how hard or intense you work out.
• Do not work out if you are overly tired.
• Take extra care if working out in cold weather.
• Wear the right equipment when playing sports. 
• Take a break and rest when you are tired.