What are the symptoms and treatment options for a labral tear of the hip (acetabular labrum tear)?

From the Guidelines

Labral Tear of the Hip: Symptoms and Treatment Options A labral tear of the hip, also known as an acetabular labrum tear, typically presents with groin pain that may radiate to the buttock or thigh, and hip catching or locking 1. The symptoms can be similar to those of other hip pathologies, such as osteoarthritis or femoroacetabular impingement (FAI).

Symptoms

• Groin pain that may radiate to the buttock or thigh
• Hip catching or locking
• Pain in the hip or groin area, especially with activity

Conservative Treatment

Initial management of a labral tear of the hip typically involves conservative treatment with physical therapy and pain management 1. This may include:

• Over-the-counter pain medications such as acetaminophen (650-1000mg every 4-6 hours) or ibuprofen (400-800mg every 6-8 hours) for 4-6 weeks
• Activity modification to avoid heavy lifting, bending, or twisting
• Physical therapy to improve hip mobility and strength

Imaging-Guided Injections

If symptoms persist, a corticosteroid injection (e.g., 40mg of triamcinolone) into the hip joint may be considered under imaging guidance 1. This can help to reduce inflammation and relieve pain.

Surgical Intervention

In cases where conservative management fails, surgical intervention such as arthroscopic labral repair or debridement may be necessary 1. This can help to repair or remove the damaged labrum and improve hip function.

Diagnostic Imaging

Diagnostic imaging such as MRI or CT arthrography may be used to confirm the diagnosis of a labral tear and to evaluate the extent of the damage 1. These imaging modalities can help to identify the location and size of the tear, as well as any associated hip pathologies.

It is essential to consult an orthopedic specialist for a thorough evaluation and personalized treatment plan. They can help to determine the best course of treatment and provide guidance on how to manage symptoms and improve hip function.

From the Research

Symptoms of a Labral Tear of the Hip

• Anterior hip or groin pain is the most common complaint among patients with a labral tear 2
• Patients may also experience kinesthetic deficits, inflexibility, muscle imbalances, and reproduction of symptoms with end-range hip motions 3
• Nonspecific symptoms can make diagnosis challenging, requiring a high index of suspicion and special attention to subtle patterns of presentation 4

Treatment Options for a Labral Tear of the Hip

• Conservative management is the initial treatment approach, including:
  • Rest
  • Non-steroidal anti-inflammatory medication
  • Pain medications
  • Modification of activities
  • Physical therapy
  • Intra-articular injection 3, 2, 5
• Surgical treatment, including labral debridement, labral repair, and labral reconstruction, is often indicated when conservative treatment fails 2, 5
• Arthroscopic labral repair using suture anchors is a technique used to treat labral tears, with a focus on minimizing morbidity and addressing secondary dysfunction 5
• A graduated management protocol, starting with activity modification and focused physical therapy, and progressing to intraarticular corticosteroid injection and arthroscopic surgery as needed, can be effective in managing adolescent patients with acetabular labral tears 6