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The labrum is a type of cartilage that surrounds the socket of ball-and-socket joints. A labrum is found in both the shoulder and the hip joint. The labrum forms a ring around the edge of the bony socket of the joint. It helps to provide stability to the joint by deepening the socket, yet unlike bone, it also allows flexibility and motion.
Injuries to the labrum have long been recognized as a possible source of pain and discomfort. Labral injuries in the shoulder are much more common, and the treatment of shoulder labral injuries has been more carefully investigated. With the recent development of arthroscopic techniques to surgically manage the hip joint, there has been increased recognition and awareness of hip labral tears.
There are two general types of hip labral tears: degenerative tears and traumatic injuries. A degenerative tear is a chronic injury that occurs as a result of repetitive use and activity. Degenerative labral tears can be seen in the early stages of hip arthritis.
A traumatic hip labral tear is usually an acute injury as a result of a sports injury, fall, or accident. Hip labral tears can be seen in association with episodes of hip dislocation or subluxation. They are commonly associated with sudden, twisting maneuvers that cause immediate pain in the hip.
The most common symptoms of hip labral tears are:
Dr. Woodworth can use specific examination tests to help determine the cause of your hip pain. X-rays of the hip are typically normal, but should be checked to evaluate for other possible causes of pain. An MRI test is helpful in evaluating the labrum, but may not always show the labrum clearly. An injection of contrast fluid into the hip joint at the time of the MRI can help show labral tears much more clearly.
Dr. Woodworth may also use a diagnostic injection to help clarify the location of the problem. To perform a diagnostic injection of the hip joint, your doctor will insert a needle into your hip joint while watching on an x-ray monitor to ensure the needle is in the proper position. The hip joint is then injected with a local anesthetic. If the injection completely alleviates the symptoms of pain, it is likely that the cause of the problem was located in the hip joint. If the pain persists, investigation into the cause of the problem should proceed to other possible diagnoses.
The treatment of hip labral tears is evolving quite quickly. Only a few years ago this injury was rarely recognized. Now it is becoming increasingly common to hear of athletes having their “hip scoped” to have their labral tear treated.
In general, the treatment of a hip labral tear usually starts off with some simple steps. Typical early treatments of a hip labral tear include:
Rest: The torn labrum in the hip can cause inflammation around the joint. Allowing the inflammation to settle down may alleviate the symptoms of the labral tear and allow return to activities.
Anti-Inflammatory Medications: Anti-inflammatory medications can be helpful in diminishing some of the inflammation in the joint. If the inflammation subsides, the symptoms may resolve.
Physical Therapy: Physical therapists can use various techniques to improve hip function by strengthening and balancing the muscles around the hip joint.
Cortisone Injection: A cortisone injection is useful not only as a treatment of the labral tear, but it can also be performed at the same time as a diagnostic injection the help determine the cause of the hip pain.
If these treatments fail to alleviate the pain associated with a hip labral tear, a hip arthroscopy procedure may be considered. During a hip arthroscopy, your surgeon places a small camera into the hip joint to see the labral tear. Your surgeon can also evaluate the cartilage of the joint, important ligaments, and other structures.
Treatment of the labral tear usually consists of shaving out the torn portion of the labrum. In some larger tears, located in an accessible area of the joint, a repair of the labrum may be attempted. Recovery from a hip arthroscopy depends on the extent of work that needs to be completed, but usually lasts 6 to 12 weeks.
Woodworth Orthopedics and Sports Medicine will help you decide how to best treat your hip labral tear. Call Dr. Woodworth today at (702) 545-6194 for an appointment.
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