What Is a Labral Tear of the Hip?
The acetabular labrum is a ring of cartilage that lines the rim of your hip socket (acetabulum). It helps to hold the thigh bone securely in the joint, while allowing flexibility and motion. It also cushions the joint and evenly distributes pressure during physical activity.
There are different types of damage that can happen to your hip labrum.
- Degeneration happens when the labrum experiences too much stress or repetitive motion over a long period of time. This type of damage can include fraying, overall breakdown over a large area, or a cyst forming inside the hip.
- Detachment is when the labrum is pulled away from the rim of the acetabulum and the underlying articular cartilage. Traumatic injuries or conditions like femoroacetabular impingement (FAI) can cause labral detachment.
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Causes of Hip Labral Tears
Labral tears can happen at any age. Causes of labral tears in the hip include:
- Activities with repetitive hip movements, like running, ballet, golf, or hockey.
- Traumatic injuries from falls, car accidents, or high-impact sports.
- Normal wear and tear over time.
- Developmental hip conditions, including:
- hip dysplasia,
- femoroacetabular impingement (FAI),
- Legg-Calvé-Perthes disease, and
- slipped capital femoral epiphysis (SCFE).
Hip Labral Tear Symptoms
A tear in your labrum can cause pain and instability in your hip, damage other tissue and cartilage in your joint, and lead to osteoarthritis over time. You might experience symptoms like:
- Sharp pain in the front of the hip;
- Clicking, locking, or a “giving way” sensation in the hip; and
- Stiffness or difficulty moving your hip.
What Does a Hip Labral Tear Feel Like?
Having a torn labrum can feel different for each person, depending on the type and the severity of the tear, but it is usually uncomfortable or painful. Pain from a labral tear is most often at the front of the hip, near the groin, but could also extend into your thigh or buttocks.
You might experience pain when rotating your leg, squatting, climbing stairs, or sitting for long periods of time. Many patients with labral tears describe feeling unsteady when putting weight on their hip, or a clicking or catching feeling when standing or participating in physical activities.
Diagnosing a Labral Tear
Your doctor can do a physical exam to check your hip’s range of motion and determine where the pain is occurring, but you might need to have other tests done to be sure that the pain is being caused by a labral tear.
- Diagnostic injection—Your doctor can inject an anesthetic into your joint to help diagnose the cause of your hip pain. If your pain is completely gone after receiving the injection, it confirms that a problem in your joint is the source of the pain. If you still feel pain after the injection, it could mean that something else is causing it.
- X-ray—An X-ray can help your doctor get a better look at the bones in your joint. He or she will check the X-ray images for conditions that might be causing your hip pain, like FAI or dysplasia.
- MRI scan—An MRI scan provides more detailed images of tissues in and around your hip joint. This will help your doctor determine the location and severity of the tear. An MRI can show labral tears even if you don’t have any symptoms.
- Arthroscopy—An arthroscopy is a surgical procedure that can be used both to diagnose and to treat certain hip conditions, including labral tears. Your doctor will insert a small camera into your joint to look for damage.
After determining what is causing your symptoms, your specialist will make a recommendation for treatment.
Treatment for Hip Labral Tears
Labral tears typically do not heal on their own, so you should have them treated both to prevent arthritis and to improve painful symptoms. There are several different treatment options that could be used, depending on the cause and severity of your condition.
Non-Surgical Treatments
Some minor labral tears can be treated without surgery. Your doctor can help identify and recommend treatments that will work best for you, including:
- Rest,
- Anti-inflammatory medications like aspirin or ibuprofen,
- Physical therapy exercises to build strength, range of motion, and stability in your hip, or
- Cortisone injections.
Surgery for Hip Labral Tears
There are several different procedures that could be used to treat labral tears, depending on what is causing them and how severe the damage is.
- Arthroscopy
If you have a labral tear, but don’t have hip dysplasia or other structural problems in your joint, you can have a hip arthroscopy to treat the damage. Your doctor will insert a small camera into your joint and then use surgical instruments to repair the damage to your labrum. This could mean either stitching the damaged tissue back together or removing it (also called debridement).
- Periacetabular osteotomy (PAO)
If hip dysplasia is causing the damage to your labrum, you can have a periacetabular osteotomy (PAO) to correct it. In this procedure, your doctor will cut and realign your bones to a normal position. This will help prevent further damage to your joint.
- Surgical dislocation and osteochondroplasty
In this procedure, your doctor will make an incision on your hip and carefully cut your thigh bone to bring it out of the joint and provide better access during the rest of the procedure. Then, your doctor can repair any tears or other problems with the labrum. After the problem has been corrected, your doctor will use screws to hold the bone back together.
This surgery is often used for more complex problems that require full labral reconstruction, or for large deformities like Perthes disease and slipped capital femoral epiphysis (SCFE). - Hip replacement (arthroplasty)
If the damage to your joint is severe, you may need to have a total hip replacement. Your doctor will remove the ball and socket of your joint and replace them with artificial parts.
Depending on what caused your labral tear and how it is treated, you should be able to return to your normal activities within several months. You may need to continue physical therapy and work with your doctor to prevent your symptoms from reoccurring.
See Our Providers for Hip Pain
You do not need a referral to see one of our specialists for hip pain.* Before you come to see us, please follow these steps:
- Get an X-ray at your local health center.
- Send us your X-ray.
- Make an appointment with our hip pain specialists by calling 801-587-7109.*
Based on your X-ray, we'll make every attempt to get you in with the right provider for the most appropriate evaluation and individualized treatment of your hip pain.
*Be sure to check with your insurance beforehand to see if they require you to have a referral to see one of our hip pain specialists.
Meet Our Patients
Former University of Utah Basketball Star Dominates Final Year of Collegiate Career After Hip Preservation Surgery
University of Utah Women’s Basketball player, Dru Gylten, felt a pinching sensation in her hip and groin area. Thinking it was normal muscle soreness, she hoped the issue would resolve itself. Unfortunately, things only got worse.
National Speed Skater Gets Back On the Ice After Hip Arthroscopy
Competitive speed skater, Blair Cruikshank, was experiencing persistent, worsening hip pain that interfered with her training. The Hip Preservation Program at University of Utah Health found an effective treatment for her hip pain to get her back on the ice at full speed.
The Dancer Who Had Hip Dysplasia
As a dancer, Tylar always got regular X-rays, but her scans showed no abnormalities. Since she had a condition called adult hip dysplasia, the symptoms only began to show later in life. Eventually the pain in her hip and knees grew more and more intense, and physical therapy was no longer helping.
Back On the Podium After Hip Replacement
Paul LaStayo, PhD, PT, CHT, is a competitive cyclist, but when his chronic hip pain got so bad, he could no longer compete. That’s when he turned to the University Orthopaedic Center for a total hip replacement surgery. And now, with his pain completely gone, Paul isn’t just back to racing. He’s back on the podium to winning.
