The ring of cartilage around the outside rim of the hip socket is called the labrum. It cushions the hip joint and helps to hold the ball at the top of the femur securely within the hip socket. Hip labral tears can occur in people who participate in high impact sports that involve sudden twisting or pivoting movements, such as football, golf, ice hockey and ballet. Congenital hip problems can also lead to labral tears over time.
Hip labral tears can occur:
- When the labrum is exposed to sudden trauma, such as dislocation of the hip joint or injury due to impact (for example, in a car accident or as the result a collision during contact sports).
- Due to repeated twisting or pivoting motions – for example, during certain types of sport – which can cause the joint to wear prematurely and may result in tearing.
As the result of congenital abnormalities of the hip which cause the labrum to degenerate and can lead to tearing.
Hip labral tears don’t always have any obvious symptoms. However, sometimes people may experience:
- Pain in the hip or groin
- Stiffness in the hip joint and reduced range of motion
- A catching sensation in the hip joint
It is important to see a consultant if you suspect you have a labral tear as it can lead to an increased risk of osteoarthritis of the hip.
Your consultant will normally want to carry out a range of diagnostic tests, as labral tears are often accompanied by other hip injuries or may be the result of congenital abnormalities. Among the tests used to diagnose labral tears and to rule out other hip problems are:
- X-rays: these are used to check for structural abnormalities and to rule out hip fractures
- MRI scans: these provide a detailed picture of your soft tissues and can help to identify tears to the labrum
- Diagnostic injections: by injecting contrast dye into your joint prior to an X-ray it is possible to get a more detailed picture of any tears. Your consultant may also recommend injecting anaesthetic into the joint space. If this relieves the pain it will confirm that the problem is located inside the joint rather than outside it.
Treatment will depend on how bad the tear is and whether you are experiencing symptoms. While some people find sufficient relief from painkillers, others may require surgery to repair or remove the damaged area of labrum. Treatments include:
- Anti-inflammatory medication to reduce inflammation and ease pain.
- Injections of corticosteroids into the joint, which provide short-term relief from pain.
- Physiotherapy: a tailored exercise programme can strengthen the hip joint, improve flexibility and increase stability. A physiotherapist can also show you how to avoid exacerbating the problem by minimising the stress on your hip joints.
- Hip arthroscopy: this is a minimally invasive surgical procedure that entails making a small incision in the skin and inserting a thin instrument called an arthroscope, which enables your consultant to see inside the joint. Torn piece of labrum may be repaired using tiny surgical instruments or if repair is not possible, the torn area of labrum may be removed.