Labral Tears of the Hip

What is the Labrum of the Hip?

The labrum of the hip is a thickened cartilage ring that lines the outer rim of the hip acetabulum (socket). The labrum functions to increase contact area in the hip and to maintain a fluid seal within the joint.

Hip Surgery, Arthroscopy, Orthopedic Specialist, Richmond VA

Arthroscopic probing of an obvious labral tear of the hip

The labrum also contains nerve fibers and tears can result in pain and mechanical symptoms. Tears of the labrum can occur for many reasons. Common causes can include trauma, repetitive activities, femoroacetabular impingement and early degenerative change.

Symptoms

Patients with tears of the hip labrum often will have deep pain within the groin or lateral aspect of the hip. The pain is usually quite deep and can not be “massaged” or “stretched.” Patients can not put their hand on the pain but there is obviously something wrong. Often a sensation of catching or popping is felt. Internal rotation of the hip can often recreate pain. Prolonged sitting, running and hip rotation (such as getting in and out of a car) can exacerbate symptoms. Often sporting activities can exacerbate symptoms and patients are forced to give up many active pursuits.

Diagnosis

MRI Arthrogram Hip Surgery Hip Disorder Richmond Virginia

MR Arthrogram of the hip demonstrating a clear tear of the labrum

Diagnosis of hip labral tears is usually done through physical examination and diagnostic imaging. The physical exam of the physician is critical. Patient history, provocative maneuvers and clinical judgment often lead to a strong suspicion of labral pathology. Diagnosis can be further substantiated by use of magnetic resonance imaging (MRI) with arthrogram. In this procedure a dye is injected into the hip joint to help identify labral pathology and then an MRI is performed.

Treatment Techniques

Arthroscopic Surgery | Knee & Hip | Richmond, VA

Arthroscopic repair of labral tear in the hip

Labral tears of the hip can be successfully treated with hip arthroscopy. Dr. Wind has extensive experience in hip arthroscopy and commonly treats labral pathology. Usually three small incisions are required to gain adequate access to the joint. Once in the joint the labral tear can be identified.

Treatment depends of the type of tear. If the tear is primarily maceration or fraying then the torn part of the labrum is excised with an arthroscopic shaver. If the labrum is stripped completely off of the acetabular bone then it can be repaired back to bone with the use of arthroscopic suture anchors.

Furthermore, if the cause of the labral tear is femoroacetabular impingement then it is important to not only treat the labral tear but the underlying impingement as well.

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