Hip labral tear

Definition

A hip labral tear is damage to the acetabular labrum, which is part of the articular head of the femur. This condition is often associated with trauma or wear and tear on the hip joint. The acetabular labrum helps keep the joint stable and allows proper hip motion.

Causes of hip labral tear

• Traumatic injuries that include falls, car accidents, sports injuries, and other instances where a force applied to the hip joint causes a tear or damage to the acetabular labrum;
• degenerative diseases. With age or due to prolonged stress on the joint, the acetabular labrum and other structures of the hip joint can undergo wear and degeneration, resulting in cracks and damage;
• avascular necrosis is a condition in which gradual deterioration of blood supply to the articular head leads to necrosis of tissues, including the acetabular labrum;
• hip dysplasia. The abnormal development of the joint causes a mismatch between the acetabular labrum and the articular head, which increases the risk of acetabular labrum damage;
• repetitive trauma and microtrauma to the hip joint can accumulate and lead to damage to the acetabular labrum;
• intense physical activity or sports with a high load on the hip joint contribute to the damage;
• some people are susceptible to acetabular labrum damage due to congenital abnormalities of the joint structure.

It is worth noting that acetabular labrum injury can be caused by a combination of factors. Treatment and prevention of the ailment depend on the specific situation and should be carried out under the supervision of qualified medical specialists.

Symptoms

The pathology may be accompanied by the following conditions:

• pain in the hip joint. The pain can be sharp, blunt, sharp, or constant. The pain may also irradiate (spread) down the leg or to the groin area. Patients feel discomfort and/or pain when trying to sit or lie on the side with the injured joint. The pain increases when the hip joint is stressed (walking, running, or climbing stairs);
• acetabular labrum injury can cause limited mobility in the hip joint. The patient has difficulty walking, lifting the leg, or turning;
• crunching and crackling in the joint. Damage to the acetabular labrum can cause sounds when the joint moves, such as crunching or crackling;
• inflammation of the tissue in the area of the injury causes swelling, redness, and a feeling of heat around the hip joint.

The above symptoms may be associated with other hip or spine conditions. 

Diagnosis in acetabular injuries

Diagnosis may include:

• medical history and physical examination. The orthopedist will discuss symptoms, medical history, and possible injuries or events that may have triggered the injury. A physical examination is also performed, including checking joint mobility, palpation for painful points, and evaluation of symmetry and structure of the pelvis and hip;
• Hip X-rays help visualize the structure of the joint and detect changes such as fractures, deformities, or osteoarthritis. However, x-rays do not always show damage to the acetabular labrum in detail;
• Magnetic resonance imaging (MRI) provides more detailed images of the soft tissues, including the acetabular labrum:
• A computed tomography (CT) scan is used to examine the bone structure of the hip joint accurately and can provide additional details about the injury;
• Ultrasound is used to evaluate soft tissue and blood flow in the joint. However, the ability to detect acetabular labruminjuries may be limited;
• diagnostic arthroscopy – a minimally invasive procedure where a small camera with a light is inserted into the joint through a small incision. This intervention allows visualization of the internal structures of the joint, including the acetabular labrum, and can be used for treatment.

The choice of diagnostic method depends on the specific situation and the doctor’s decision. After receiving the diagnostic results, the orthopedic trauma surgeon can determine the extent of the acetabular labrum injury and develop the most appropriate treatment plan.

Treatment of acetabular labrum injury of the hip joint

Treatment of acetabular labrum injury depends on many factors, including the extent of the injury, symptoms, the patient’s age, and general health. Therapy includes conservative methods or, if necessary, surgery.

Conservative treatment:

• rest and limitation of loads. In the case of minor acetabular labrum injuries, the hip joint should be allowed to recover by limiting its load. Crutches or other support devices are recommended;
• physiotherapy. Special exercises and rehabilitation techniques can help strengthen muscles, improve joint mobility and reduce pain;
• medication treatment. Non-steroidal anti-inflammatory drugs can reduce inflammation and relieve pain;
• Corticosteroid injections are needed to reduce inflammation and pain.

Surgical treatment

Arthroscopy and stapling of the acetabular labrum

The arthroscopic method allows the orthopedic surgeon to visualize the internal structures of the joint using a camera inserted through small incisions/punctures in the skin. Depending on the nature of the injury, the acetabular labrum can be “repaired” using sutures and reattached using special techniques.

Arthroscopy is a minimally invasive intervention that ensures the fastest possible rehabilitation. Most doctors worldwide prefer this method for curing injuries and pathologies of the musculoskeletal system.

Open surgery and acetabular labrum repair

More severe injuries or deformities may require open surgery. Through incisions in the patient’s tissues, the surgeon can directly access the hip joint and repair or reconstruct the acetabular labrum.

Hip arthroplasty

If the damage to the hip joint is significant and has led to degenerative changes, arthroplasty, i.e., replacement of the joint with a prosthesis, may be necessary. During this operation, the damaged structures of the joint, including the acetabular labrum, are replaced with a prosthesis made of wear-resistant metal, which completely replaces your joint.

These surgical treatments require careful preparation, determination of indications, and discussion with an orthopedic surgeon. After the intervention, the patient will require physical therapy and rehabilitation to restore mobility and strength to the joint.

All these treatment options are available in more than 760 hospitals worldwide (https://doctor.global/results/diseases/hip-labral-tear). For example, Hip surgery can be performed in these countries for following approximate prices:

Turkey $9.5 K in 14 clinics

China $29.2 K in 6 clinics

Germany $29.9 K in 35 clinics

Israel $44.2 K in 13 clinics

United States $48.1 K – 132.0 K in 15 clinics.