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Hip labral tear
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
A hip labral tear involves the ring of soft tissue that follows the outside rim of the socket of your hip joint. This ridge of cartilage, called a labrum, works a little like a suction cup to help hold your hip joint together.
Athletes who participate in such sports as ice hockey, soccer, football, golfing and ballet are at higher risk of developing a hip labral tear. Structural abnormalities of the hip can also lead to a hip labral tear.
Signs and symptoms include hip pain or a "catching" sensation in your hip joint. Initial treatment may include pain relievers and physical therapy. Using arthroscopic techniques, surgeons can remove loose fragments from within the joint and trim or repair the hip labral tear.
Symptoms
Many hip labral tears cause no signs or symptoms. Occasionally, however, you may experience one or more of the following:
- A locking, clicking or catching sensation in your hip joint
- Pain in your hip or groin
- Stiffness or limited range of motion in your hip joint
Causes
The cause of a hip labral tear may be:
- Trauma. Injury to or dislocation of the hip joint — which can occur during car accidents or from playing contact sports such as football or hockey — can cause a hip labral tear.
- Structural abnormalities. Some people are born with hip problems that can accelerate wear and tear of the joint and eventually cause a hip labral tear.
- Repetitive motions. Sports-related and other physical activities — including the sudden twisting or pivoting motions common in golf or softball — can lead to joint wear and tear that ultimately results in a hip labral tear.
- Osteoarthritis. Degenerative changes can increase the friction inside your hip joint, which can lead to a hip labral tear.
Risk factors
The following factors may increase your risk of a hip labral tear:
- Overuse. People who participate in sports or other activities that require repeated twisting or pivoting motions are more likely to experience a hip labral tear.
- Pre-existing hip problems. Conditions or diseases that increase the amount of friction within the hip joint may increase the risk of a hip labral tear.
Complications
A hip labral tear may predispose you to develop osteoarthritis in that joint in the future.
Preparing for your appointment
While you may initially consult your family physician, he or she may refer you to a doctor who specializes in hip disorders or sports medicine.
What you can do
You may want to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you've had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions you want to ask the doctor
What to expect from your doctor
Your doctor may ask:
- Where exactly does it hurt?
- When did the pain start?
- Did anything precipitate it?
- Does any action make the pain better or worse?
During the physical exam, your doctor will move your leg, and especially your hip joint, around in various positions to check for pain and evaluate your hip's range of motion. He or she may also want to watch you walk. Your doctor may also check the musculoskeletal and neurological health of your hip joint and leg by testing your:
- Reflexes
- Muscle strength
- Muscle tone
- Sensation
- Coordination
- Balance
Tests and diagnosis
A hip labral tear rarely occurs in isolation. In most cases, other structures within the hip joint have also sustained injuries. Diagnostic tests can help determine exactly what's going on inside your joint.
Imaging scans
- X-rays. X-rays are excellent at visualizing bone. They can check for fractures and for structural abnormalities.
- Magnetic resonance imaging (MRI). Using a strong magnetic field, MRIs provide detailed images of soft tissues. A contrast material may be injected into the hip joint space to better define a labral tear that may be present.
Anesthesia injection
Hip pain can be caused by problems within the joint or outside the joint. Your doctor may suggest injecting anesthesia into the joint space. If this relieves your pain, it's likely that your problem is inside your hip joint.
Treatments and drugs
Treatment choices will depend on the severity of your symptoms. Some people recover with conservative treatments in a few weeks, while others may require arthroscopic surgery to repair or remove the torn portion of the labrum.
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, others), can relieve pain and reduce inflammation.
Therapy
A physical therapist can teach you exercises to maximize hip range of motion and hip strength and stability. A physical therapist can also analyze the movements you perform that put stress on your hip joint and help you avoid these forces.
Surgical and other procedures
If you have a hip labral tear and experience hip pain for more than four weeks, your doctor may recommend arthroscopic surgery — in which a fiber-optic camera and surgical tools are inserted via small incisions in your skin.
Depending on the cause and extent of the tear, the surgeon may cut out and remove the torn piece of labrum or repair the torn tissue by sewing it back together.
- Nuccion SL, et al. Intra-articular derangements. In: DeLee JC, et al. DeLee and Drez's Orthopaedic Sports Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2003. http://www.mdconsult.com/das/book/body/116370898-3/791075188/1103/793.html#4-u1.0-B0-7216-8845-4..50027-2--cesec33_3306. Accessed Jan. 12, 2009.
- Shindle MK, et al. Arthroscopic management of labral tears in the hip. Journal of Bone and Joint Surgery. 2008;90(suppl):2.
- Bharam S. Labral tears, extra-articular injuries, and hip arthroscopy in the athlete. Clinics in Sports Medicine. 2006;25:279.
- Neurological tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Jan. 13, 2009.
