Hip Labral Tear – Overview

Transcript

“Many patients are referred to me for the diagnosis of a hip labral tear. And just to describe really what this means is that if you think of the anatomy of the hip joint, our hips are these ball and socket type joints, okay. And so you have the ball of the femoral head, the socket, or we call the acetabulum. And inside of that space is the joint itself, fill of articular cartilage as well as the soft tissue that goes around the whole rim of the cup or the acetabulum called the labrum. This labrum, in normal anatomic terms, helps to improve the suction of that stability of the ball and the socket, as well as a cushion to help offload the articular cartilage and decrease the risk of developing osteoarthritis or wear and tear arthritis. The labrum can be torn in a number of different scenarios, eliciting the pain and discomfort, or even if patient who got an MRI at the head will be referred to me because it was noticed on the MRI that it was torn. A labrum can be torn even with patients not even knowing that it was torn in the first place.

Patients who are at high risk of a tear, most importantly, are patients who are at high risk of developing the tear to begin with because of their anatomy. Patients with hip dysplasia have a unique anatomy, which actually has a more of a shallow socket or shallow acetabulum, which is not quite as circumferential around the ball and therefore places more risk in the top part of the socket of that labrum. Patients with hip dysplasia have a very hypertrophic or thickened labrum because of this problem over their entire lifetime, and are more risk for developing tears over time. Patients also with what’s called femoral acetabular impingement, or FAI, almost have a different problem where they have too much coverage and the labrum gets impinged when the ball comes up as in with hip flexion or different activities that impinge that labrum and can cause degenerative tearing of the labrum as well. In both of these scenarios, the patient is set up for this problem because of their anatomy. Other patients with otherwise normal anatomy can develop labral tears from an injury, versus even a car accident or just them being involved in recreational sports can cause a unique acute tear of the labrum, rather than more of a chronic or long-term degenerative issue. Patients with an acute tear are more likely to benefit from a surgical or arthroscopic repair of that tear as well as shaving down potentially some of the risk factors such as the impingement syndrome we discussed earlier.”