Hip labral tear

A hip labral tear is an injury of the hip labrum. The labrum is the cartilage that lines the acetabulum (the hip socket in which the head of the femur or thigh bone sits). A labral tear is rarely an injury that happens suddenly. Rather, it often occurs over time when an underlying problem with the hip joint puts additional strain on the labrum. Sometimes, a labral tear can be prompted by trauma from an accident or sports injury, a structural abnormality, or repetitive motion such as long-distance running.

When the labrum is damaged, the person will experience:

• Hip pain or groin pain
• Stiffness or limited range of motion in the hip joint
• A hip joint that locks, clicks or “catches”

Other symptoms, often associated with hip dysplasia or hip impingement, include:

• Stiffness in the hip, thigh, or groin
• Inability to flex the hip beyond a right angle
• Instability in the hip
• Limping when walking
• Unequal leg lengths

At the Penn Hip Preservation Center, our specialists know that for every labral tear we see, there is usually an underlying anatomical problem that has weakened or put the labrum at risk. In men, this problem is usually hip impingement. In women, it is most often hip dysplasia. In either case, if left untreated these conditions can lead to reinjury and, over time, osteoarthritis, and ultimately hip replacement.

With every labral tear, we take the time to evaluate the anatomy and structure of your hip joint to determine if there is an underlying cause for your injury. This is done using advanced imaging tests such as MRI and 3-D CT scans. We then develop a treatment plan that will address the tear as well as the underlying cause. This comprehensive approach addresses your pain and function problems, prevents future hip labral injuries, and preserves the joint in the long term.

When an underlying condition such as hip impingement or hip dysplasia is found, we treat both the labral tear and the underlying problem to reduce the risk of reinjury and ensure optimal outcomes.

Depending on the severity of the labral tear, a torn hip labrum may be treated with either a minimally invasive procedure or open surgery.

• Hip arthroscopy: This minimally invasive approach is our preferred method for repairing labral tears and correcting any underlying conditions. During hip arthroscopy, an arthroscope – a tiny tube with a lens and light source – is inserted into the hip joint through a small incision. This allows us to view the hip joint and surrounding structures and treat the problem. During hip arthroscopy we may perform labral tear repair, or labral reconstruction (if the labrum is not big enough). To repair a labral tear, we use anchors (sutures) that wrap around the labrum and pull it back into the bone. At this time, we will also treat the underlying condition, whether it’s hip dysplasia or hip impingement.
• Surgical hip dislocation: In rare cases, patients will require an open surgical approach to treatment. This is recommended when a person has a complex problem – such as a lot of extra bone or a structural deformity – in addition to a labral tear. During surgical hip dislocation, the femoral head is moved away from its normal resting place in the acetabulum. This allows us access to the joint to correct the problem. Once treatment is done, the femur is secured back into place with screws.

Depending upon the underlying condition that caused the labral tear, you can expect to be on crutches for about two weeks following surgery. At four weeks you can bear weight. You’ll return to normal athletic activities between two- and four-months following surgery.