From the Guidelines
A hip labrum tear typically causes symptoms including pain in the hip or groin, clicking or locking sensations in the hip, stiffness, limited range of motion, and instability. Treatment begins with conservative approaches including rest, activity modification, and over-the-counter pain medications like ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) for 1-2 weeks, as suggested by 1. Physical therapy focusing on hip strengthening and stability exercises is crucial and typically involves 2-3 sessions weekly for 6-8 weeks. For persistent pain, corticosteroid injections may provide temporary relief, as noted in 1. If conservative treatments fail after 3-6 months, arthroscopic surgery may be necessary to repair or remove the damaged labrum tissue, followed by a rehabilitation period of 3-6 months, as indicated by 1. Hip labrum tears occur when the cartilage ring surrounding the hip socket becomes damaged, often due to repetitive motions, structural abnormalities like femoroacetabular impingement, or trauma, as discussed in 1. Early diagnosis and appropriate treatment are important to prevent further joint damage and chronic pain, as the labrum has limited blood supply and poor natural healing capacity. Some key points to consider in the diagnosis and treatment of hip labrum tears include:
- The use of MRI with or without arthrography for evaluating labral tears, as recommended by 1
- The potential benefits of high-resolution 3 Tesla (T) MRI for improving the visualization of the acetabular labrum and the hyaline articular cartilage, as noted in 1
- The importance of physical therapy and conservative management in the treatment of hip labrum tears, as suggested by 1
- The role of arthroscopic surgery in the treatment of hip labrum tears, as indicated by 1.
From the Research
Symptoms of Hip Labrum Tear
- Anterior hip or groin pain is the most common symptom, as reported in studies 2, 3, 4, 5, 6
- Buttock pain is less common, but can also occur 2
- Mechanical symptoms such as clicking, locking, and giving way are frequently present 2, 3
- A positive anterior hip impingement test is the most consistent physical examination finding 2, 3
Treatment Options for Hip Labrum Tear
- Conservative treatment typically begins with relative rest and non-steroid anti-inflammatory agents, with physical therapy (PT) being controversial 2, 3
- Surgical treatment is often necessary, which entails arthroscopic debridement of labral tears and surgical repair of associated structural problems 2, 3, 5
- Hip arthroscopy has had successful outcomes when compared with physical therapy alone, especially for femoroacetabular impingement (FAI)-associated labral tears 5
- Primary labral reconstruction has emerged as a good option for irreparable labral tears 5
- Non-operative management may have its role in treating patients with FAI, but hip arthroscopy has developed a successful track record in being able to treat cam and pincer lesions, chondral damage, and labral injuries 5
Diagnosis of Hip Labrum Tear
- Evaluation usually begins with plain radiographs to assess for dysplasia, degeneration, and other causes of pain 2
- Magnetic resonance arthrography (MRA) is the diagnostic test of choice, with arthroscopy being the gold standard 2, 3
- Magnetic resonance imaging (MRI) and computed tomography scans are unreliable for diagnosis, but can be used to diagnose labral tears and cartilage damage associated with FAI 4, 5
- A diagnostic injection should be performed if there is uncertainty that the pain is intra-articular in origin 6