Hip Labral Tear

Hip Labral Tear

The hip labrum is a fibrocartilaginous structure that resides on the rim of the acetabulum. This means it is a piece of cartilage, separate from that which lines the joint, that runs along the edge of the socket and has multiple functions.

A significant amount of research is continuing to determine the specific role that it plays in hip function, but we know that if it is torn, it can certainly be the source of hip pain and dysfunction. Although it is a very unique structure, it is not too different from the meniscus in the knee or the labrum in the shoulder, which have been studied extensively for many years already.

Through expanding research into the hip labrum, it has been discovered that it not only has a significant functional role in maintaining hip pressure, fluid balance, and hip stability, but also has a remarkable collection of nerve fibers and sensory organs within it that can signal pain when it has been damaged.  Unfortunately, the blood supply to the labrum is very limited, and once it is damaged, it has a poor ability to heal.

Special techniques can be utilized by skilled arthroscopic surgeons to repair the labrum in some cases, but still the majority of labral tears are not repairable and they require a partial removal. This is being performed arthroscopically (microscopically) more and more frequently. Physical therapy alone has very limited utility for hip labral tears as an isolated problem.

Labral tears can occur by themselves from acute injury or "wear-and-tear" over time, however, they more commonly occur as a result of an underlying bone abnormality in shape or size known as femoroacetabular impingement (FAI). This disorder characterizes a structural abnormality in the bones of the hip joint that can put a patient at risk for damage to the labrum with certain activities such as running, cycling, jumping, soccer, tennis and gymnastics. These particular activities put the bones of the hip joint in positions where the labrum can be pinched or crushed causing repetitive damage.

The evaluation of hip labral tears includes specific physical exam tests that will be performed in the clinic, but also specialized X-rays and a special MRI to evaluate all areas of the hip joint. Research has clearly demonstrated that all aspects of the underlying problem must be treated (bone shape and size, cartilage damage and labral tears) in order to have a reliable and successful outcome.