Hip Labral Tear Treatment

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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What is a Hip Labral Tear?

A hip labral tear is a condition characterised by damage to the labrum, a fibrous ring of tissue surrounding the socket part of the hip joint (acetabulum). The hip joint itself is a ball-and-socket joint, where the rounded head of the femur (thighbone) fits into the acetabulum of the pelvis. The labrum acts like a rubber seal to maintain the position of the femoral head within the hip socket, ensuring smooth and stable movement. When a tear in the labrum occurs, it can compromise the integrity of the hip joint, leading to discomfort and impaired mobility.

This type of injury disrupts the normal function of the labrum, leading to issues such as pain, limited range of motion, and sensations of clicking or locking in the hip joint.

Causes of Hip Labral Tears

Hip labral tears can result from a variety of factors, each contributing to the weakening or damage of the labrum:

  • Traumatic Injury
    One of the most prevalent causes of hip labral tears is trauma to the hip area. This is often seen in athletes engaged in high-impact sports or activities that involve repetitive twisting and bending, such as soccer, martial arts, and hockey. Traumatic injuries can also occur due to accidents or sudden, forceful movements.
  • Underlying Hip Deformities
    Conditions like hip dysplasia, where the hip socket does not completely cover the ball of the hip joint, and femoroacetabular impingement (FAI), where extra bone grows along one or both of the bones that form the hip joint, can increase the risk of labral tears. These deformities can cause abnormal contact between the hip bones, putting additional stress on the labrum.
  • Age-Related Wear and Tear
    As individuals age, the labrum can weaken due to general wear and tear. This deterioration over time makes the labrum more susceptible to tearing, especially during routine activities.
  • Degenerative Conditions
    Conditions such as osteoarthritis, which involve the gradual breakdown of joint cartilage and the underlying bone, can also lead to labral tears. As the joint degrades, the labrum may be more likely to incur damage.

Symptoms and Signs

Individuals with a hip labral tear may experience a range of symptoms, which can vary in intensity and frequency:


  • Pain: The most commonly reported symptom is pain in the hip, groin, or buttock area. This pain is often exacerbated by activities that involve high-impact or prolonged bending and turning, such as sports, long periods of sitting or walking, or even daily activities like putting on shoes and socks.
  • Clicking or Locking Sensations: Many individuals report feeling a clicking, locking, or catching sensation in the hip joint during movement. This can be a sign of the labrum being trapped or pinched within the joint.
  • Stiffness and Limited Range of Motion: A hip labral tear can lead to stiffness in the hip joint, making it difficult to move the leg in certain directions. The range of motion may be noticeably reduced compared to the unaffected side.
  • Instability or Unsteadiness in the Hip: Some people may feel that their hip is not as stable as it should be, which can manifest as a sense of unsteadiness or weakness in the hip area.

Diagnosis

The process of diagnosing a hip labral tear involves several steps to accurately identify the condition and assess the extent of the injury.

Medical History Review

Initially, the hip specialist will inquire about the patient’s medical history, including any previous hip injuries, sports participation, and the onset and nature of the current symptoms.

Physical Examination

A hip specialist will conduct a thorough physical examination. This includes checking the range of motion in the hip, assessing for any pain or discomfort during movement, and performing specific tests to provoke symptoms related to a labral tear.

Imaging Tests

MRI scans are often used to confirm a hip labral tear. It can reveal the presence and extent of a tear. While X-rays or CT scans cannot show soft tissue like the labrum, they may be used to identify any associated bony deformities in the hip.

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Non-Surgical Treatment Options

Non-surgical treatments are typically the first line of approach for hip labral tears, especially in cases where the tear is not extensive or the patient has specific reasons to avoid surgery. These focus on alleviating symptoms and improving hip function.

  • Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are commonly prescribed to relieve pain and reduce inflammation. These medications can provide temporary relief and help manage symptoms during the initial stages of treatment.
  • Physical Therapy - Hip specialists may suggest engaging in a physical therapy program tailored to the individual’s condition. This may include exercises to enhance the range of motion, strengthen hip and core muscles, and improve stability.
  • Activity Modification - In the early stages of the condition, hip specialists may guide patients to modify their activities to avoid motions or stresses that could worsen the labral tear. This might involve temporary restrictions on certain sports or daily activities and finding alternative ways to perform tasks that minimise hip stress.
  • Corticosteroid Injections - If pain and inflammation are not adequately controlled with oral medications and physical therapy, corticosteroid injections may be considered. These injections are injected directly into the hip joint and are usually guided by imaging techniques such as an X-ray or ultrasound.

Surgical Treatment Options

When non-surgical treatments are not effective in alleviating the symptoms of a hip labral tear, surgical options may be considered. Many hip labral tears are treated using hip arthroscopy, a minimally invasive procedure which can aid the repair or removal of the damaged labrum with smaller incisions and greater accuracy.

Labrum Repair or Removal

Depending on the nature and severity of the tear, the hip surgeon may either repair the torn labrum by sewing it back together or remove the torn portion. The decision is based on factors such as the quality of the labral tissue and the overall stability of the hip joint.

During the procedure, bony deformities of the acetabulum (socket) and femoral head and neck (ball) which are associated with the tear can also be addressed. This could involve reshaping the bones to prevent future impingement and tearing.

Prevention Strategies

While not all hip labral tears can be prevented, especially those due to structural abnormalities or degenerative changes, measures can be taken to help reduce their risk.


  • Proper Warm-Ups to Increase Blood Flow and Improve Hip Flexibility: Before participating in any sports or physical activities, engage in proper warm-up exercises to increase blood flow to the muscles and improve flexibility. This can potentially reduce the risk of injuries.
  • Strengthen Hip and Core Muscles: Regularly engaging in exercises that strengthen the muscles around the hip and the core can provide better stability and support for the hip joint. Stronger muscles can help absorb the forces exerted on the hip during activities, decreasing the stress on the labrum.
  • Maintain Flexibility of the Hip Muscles and Joints: Flexibility in the hip muscles and joints can help prevent injuries. Stretching exercises, particularly for the hip flexors, glutes, and hamstring muscles, can be beneficial.
  • Protect the Hip from Injury by Using Proper Techniques: Use the correct techniques and body mechanics during sports and physical activities. This is especially the case for sports that involve twisting, turning, and high-impact movements.
  • Modify Strenuous Activities: If certain movements or activities cause hip pain or discomfort, modifying or avoiding these activities can help prevent further injury to the labrum.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany

 

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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
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Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed

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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    How Long Is Recovery from a Hip Labral Tear?

    Recovery time from a hip labral tear varies depending on the treatment approach. For non-surgical treatments like medication and physical therapy, recovery can take 8 to 12 weeks. If surgery is necessary, the timeline extends, with low-intensity exercise possible in about three months and a return to regular routines potentially taking more than four months​​.

    What Happens if a Hip Labral Tear Goes Untreated?

    Leaving a hip labral tear untreated can lead to chronic pain and instability in the hip, potentially causing further damage. These conditions may require more intensive treatments, including surgical intervention, in the future. Consult our hip specialist to explore treatment options and prevent the progression of the condition​​.

    Can Hip Labral Tears Heal on Their Own?

    Hip labral tears typically do not heal on their own and require intervention for improvement. Continuing regular activities without treatment may worsen the condition, leading to more severe injuries. Early consultation with our hip specialist can help lead to appropriate management and treatment​​.

    Can You Walk with a Hip Labral Tear?

    Walking with a hip labral tear is possible, but it may cause pain or discomfort, especially during extended periods of activity. Consult our hip specialist for an individual assessment and guidance on activity levels.

    What Is the Best Exercise for a Hip Labral Tear?

    The best exercises for a hip labral tear focus on strengthening the muscles around the hip and improving flexibility. This includes activities that enhance hip and core strength, stability, and range of motion. Exercises should be tailored to individual needs to avoid exacerbating the condition.