The labrum is a rubbery ring of cartilage that sits around the rim of the acetabulum (hip socket). This structure has an important role in increasing the stability of the hip and cushioning the bony surfaces of the acetabulum and the femoral head that sits within it. Damage to the labrum is often referred to as a labraltear. This may occur suddenly as the result of an injury to the hip or, damage may develop slowly over time through repeated “micro-trauma” such as being pinched between bony surfaces in the case of femeroacetabular impingement (FAI).
People who play sports or who have an underlying hip condition like acetabular dysplasia (an abnormally shaped hip socket) are more likely to experience a labral tear. Symptoms of a labral tear can include pain, often felt in the groin and made worse with squatting or twisting of the hip. A catching or clunking feeling in the hip during the activity may also be present.
Your surgeon will spend time talking with you and then perform an examination of your hip. If a labral tear is suspected, you surgeon may order investigations such as an MRI scan to confirm the diagnosis. Occasionally, an injection into the hip that contains steroids and an anaesthetic might be recommended. If pain is relieved by this procedure, it supports the diagnosis of a labral tear.
Not all labral tears need surgery. Sometimes they don’t even hurt at all. Over time, many people develop tears in the labrum with attrition over many years of activity and wearing out of the labrum with age. Your surgeon will need to consider carefully whether a tear seen on an MRI scan is in fact what is causing your pain, or whether there is something else as the cause.
Most of thelabrum does not have a good supply of blood vessels to feed it and instead, receives nourishment largely from the fluid inside the joint. As such, a labral tear might be very slow to heal or it may not heal at all without intervention. Initially, your surgeon may recommend non-surgical treatment which might include:
- A trial of medication, such as non-steroidal anti-inflammatories (NSAIDs)
- Activity modification and rest
- Physiotherapy to help strengthen the muscles around your hip
- An injection into the hip
An operation might be recommended if you:
- Continue to have symptoms after trialling non-surgical treatments
- Have an underlying hip condition such as femeroacetabular impingement which is contributing to your symptoms
If there is old age, degeneration or arthritis present in your hip it will be unlikely that the labraum can be repaired. In these conditions, surgeons find that the labrum doesn’t repair no matter how good the surgery and the patients symptoms will not improve.