HIP LABRAL TEAR
Hip joints are a large ball and socket joints. The head of your femur, or thigh bone, is rounded like a ball to fit into the acetabulum or hip bone socket. The joint is held together by a number of soft tissues including the labrum. The labrum is a fibrous cartilage that surrounds the rim of your acetabulum, sealing the femoral head inside. It is essential to keeping your hip joint stable. Hip labral tear refers to damage done to the labrum and/or cartilage either over time (femoroacetabular impingement) or from a sudden injury. Cartilage damage can become a serious injury since it does not heal easily; cartilage cells cannot repair themselves. Hip labral tears can lead to joint instability and further orthopedic issues for your hip joint in the future.
Hip labral tears are usually the result of the repetitive movement, which is common for athletes. Patients who run, play contact sports like football, or sports that require sudden twisting motions of the hip like golf are more susceptible to hip labral tears. Those who have CAM (irregularity of bony contour of head part) or Pincer morphology (over coverage of ball socket) of the hip are also more likely to suffer from a hip labral tear. Repetitively moving your hip beyond its natural range of motion will cause tiny tears in the labrum, which can cause damage to joint cartilage and eventually leading to a more painful issue.
You can also tear a hip labrum with a sudden injury. Hip dislocations are usually accompanied by labral tears of the hip. It takes a large amount of force to dislocate your hip; it is usually from a car accident or a high impact sports injury. Elderly patients are also more at risk of injuring their hip during a fall since their tissue and bone cells are much less able to repair themselves.
You are more at risk to tear the labrum of your hip if you have CAM, pincer or mixed morphology of hip or some sort of physical deformity in the lower half of your body. Unequal leg length or conditions that cause you to walk with a limp will stress your hip joint. Over a period of time this can damage your labrum and cause joint instability.
Stiffness or impeded range of motion in your hip
Pain in the front of your hip or groin region
Pain that may radiate down through the buttocks
Pain gets worse with standing, walking or other activity
Locking or catching in your hip joint as you move
Feeling of instability or weakness on that side of your body
Hip labral tears left untreated are a chronic problem. They may alter your gait, which can lead to other knee, back, and neck issues. It will also make the joint more unstable which will accelerate the onset of osteoarthritis.
Physical exam which should make a hip labral tear simpler to diagnose. Doctor will move your leg around manually to test the range of motion in your hip joint and the extent of your pain. An X ray can reveal abnormal joint positioning or other issues that may exist besides your labrum tear. An MRI will reveal the actual damage done to the labrum.
TREATMENT FOR HIP LABRAL TEAR
Many hip labral tears can be treated conservatively, especially if they are obtained gradually and treated early.
Physical Therapy – After being diagnosed with a hip labral tear, advise you to rest for a short period of time to allow inflammation to subside and then begin physical therapy. Your early physical therapy sessions will also include anti-inflammatory modalities, including ice and ultra sound. Your physical therapist will help you stretch your tissues to increase range of motion and guide you through strengthening exercises. It is important to target the muscles that surround the hip joint so they can properly support your joint and keep your cartilage damage from progressing while stabilizing the joint.
Injection Therapy – A corticosteroid injection is administered to provide you long term relief from inflammation. The medicine is injected directly into the joint to reduce inflammation for approximately six months, though results depend on each individual. This is useful in relieving pain so that physical therapy routines are made easier.
If conservative methods fail to help your hip feel better after a few months, Surgery(hip arthroscope) is necessary. Hip arthroscopies are minimally invasive procedures that limit pain, complications, and recovery time after surgery. Hip arthroscopies are performed by making a small incision at the side of your hip where a small camera can be inserted so your orthopedic surgeon may visualize the inside of your joint. Another tiny incision is made for the tools , will need to debride your hip’s labrum. This means that we will cut away portions of the labrum that are damaged and causing destabilizations. Large tears in the hip labrum may be able to be repaired using biodegradable suture anchors.
Arthroscopic surgery, because it uses small incisions and tools, does not do damage to the surrounding tissues as open surgery does. For this reason, you will need less time to recover and have less of a risk of pain or tissue scarring. Recovery should last about 6-12 weeks. You will be able to move freely, though you should not perform strenuous activity. Physical therapy is still important following arthroscopies in order to make sure the joint heals with a good range of motion and the muscles are restrengthened.