Hip joints are a type of ball and socket joint. To fit into the acetabulum, or hip bone socket, the head of your femur, or thigh bone, is rounded like a ball. A number of soft tissues, including the labrum, hold the joint together. The labrum is a fibrous cartilage that wraps around the rim of the acetabulum and seals the femoral head inside. It is critical for maintaining hip joint stability. Hip labral tears are caused by damage to the labrum and/or cartilage that occurs over time (femoroacetabular impingement) or as a result of a sudden injury. Cartilage damage can be severe because it does not heal quickly; cartilage cells cannot repair themselves. Hip labral tears can cause joint instability and other orthopaedic complications.
Causes
Hip labral tears are typically caused by repetitive movement, which is prevalent in athletes. Patients who run, participate in contact sports such as football, or sports that demand abrupt twisting motions of the hip such as golf are more prone to hip labral tears. Hip labral tears are more common in people who have CAM (irregularity of bony contour of head part) or Pincer morphology (over covering of ball socket). Moving your hip beyond its usual range of motion repeatedly causes microscopic tears in the labrum, which can damage joint cartilage and eventually lead to a more painful problem.
A hip labrum can also be torn by a rapid injury. Hip dislocations are frequently accompanied by hip labral tears. It takes a lot of effort to dislocate your hip; it usually happens in a car accident or from a high-impact sports injury. Elderly patients are also more likely to injure their hip during a fall because their tissue and bone cells are less capable of self-repair.
If you have CAM, pincer or mixed morphology of the hip, or some sort of physical deformity in the bottom half of your body, you are more likely to rupture the labrum of your hip. Hip joint stress is caused by unequal leg length or problems that lead you to walk with a limp. This can injure your labrum and create joint instability over time.
Symptoms
- Hip stiffness or restricted range of motion
- Pain at the front of your hip or groin region
- Pain that may extend down through your buttocks
- Pain that worsens with standing, walking, or other exercise
- Locking or catching in your hip joint when you move
- Feeling of instability or weakness on that side of your body
Untreated hip labral tears become a chronic condition. They may cause changes in your gait, which can lead to knee, back, and neck problems. It will also make the joint more unstable, hastening the onset of osteoarthritis.
Diagnosis
A physical exam that should aid in the diagnosis of a hip labral tear. The doctor will manually move your leg to assess the range of motion in your hip joint and the severity of your pain. An X-ray may indicate aberrant joint alignment or other abnormalities in addition to your labrum rupture. An MRI will indicate the extent of the labrum’s injury.
HIP Labral Tear Treatment
Many hip labral tears can be treated conservatively, especially if they are obtained gradually and treated early.
Conservative
Physical Therapy: If you have been diagnosed with a hip labral tear, your doctor will urge you to rest for a short amount of time to enable the inflammation to diminish before beginning physical therapy. Anti-inflammatory treatments such as ice and ultrasound will be used in your early physical therapy sessions. Your physical therapist will assist you in stretching your tissues and guiding you through strengthening exercises to promote range of motion. It is critical to target the muscles that surround the hip joint so that they can correctly support your joint and prevent cartilage loss while stabilising the joint.
Injection Therapy: A corticosteroid injection is given to help you with long-term inflammation relief. The medication is injected directly into the joint to reduce inflammation for around six months, however results vary from person to person. This is beneficial in decreasing pain and making physical therapy exercises easier.
Surgery
If conservative measures do not relieve your hip pain after a few months, surgery (hip arthroscope) is required. Hip arthroscopies are minimally invasive surgical procedures that reduce discomfort, complications, and recovery time. Hip arthroscopies are conducted by making a small incision on the side of your hip and inserting a small camera to allow your orthopaedic surgeon to see inside your joint. Another small incision is created to accommodate the tools required to debride your hip’s labrum. This implies we will remove sections of the labrum that are damaged and creating destabilizations. Large tears in the hip labrum may be repairable with biodegradable suture anchors.
Post-Surgery
Because it employs small incisions and equipment, arthroscopic surgery does not cause injury to the surrounding tissues like open surgery. As a result, you will require less time to recuperate and will be less likely to experience pain or tissue scarring. The recovery period should extend between 6 and 12 weeks. You will be able to walk about freely, but you should avoid vigorous activities. Physical therapy is still necessary after arthroscopies to ensure that the joint heals with a good range of motion and that the muscles are strengthened.