A comprehensive review of hip labral tears

Abstract

The hip labrum has many functions, including shock absorption, joint lubrication, pressure distribution, and aiding in stability, with damage to the labrum associated with osteoarthritis. The etiology of labral tears includes trauma, femoroacetabular impingement (FAI), capsular laxity/hip hypermobility, dysplasia, and degeneration. Labral tears present with anterior hip or groin pain, and less commonly buttock pain. Frequently, there are also mechanical symptoms including clicking, locking, and giving way. The most consistent physical examination finding is a positive anterior hip impingement test. Because of the vast differential diagnosis and the need for specialized diagnostic tools, labral tears frequently go undiagnosed during an extended period of time. Evaluation usually begins with plain radiographs to assess for dysplasia, degeneration, and other causes of pain. While magnetic resonance imaging (MRI) and computed tomography scans are unreliable for diagnosis, magnetic resonance arthrography (MRA) is the diagnostic test of choice, with arthroscopy being the gold standard. Typically, treatment begins conservatively with relative rest and non-steroid anti-inflammatory agents, with physical therapy (PT) being controversial. Often, surgical treatment is necessary, which entails, arthroscopic debridement of labral tears and surgical repair of associated structural problems.

Subchondral Insufficiency Fracture of the Femoral Head may be Associated with Hip Dysplasia: A Pilot Study

“…Increased stress on the acetabular rim also reportedly is associated with acetabular lesions such as labral tears and ganglion cysts [9,10]. Resultant labrum tears in dysplastic hips are associated with the development of osteoarthritis [3,4]. Therefore, we presumed the increased joint contact pressure on the anterolateral edge of the dysplastic acetabulum could produce a subchondral fracture in SIF.…”

Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging

“…These include: post-traumatic, associated with FAI, capsular laxity/hip hypermobility, dysplasia, and degenerative. 82 Additionally, acetabular labral tears at the 3-o'clock position suggest the diagnosis of iliopsoas tendon impingement. 83 Similar to patients who present with FAI, post-traumatic labral and osteochondral injury is more prevalent in the athletic population, where repetitive, end-range hip motion is desired.…”

Clicking hip in a postmenopausal woman

“…1,3 Labral tears may be asymptomatic. In a study involving 70 asymptomatic individuals (mean age 26 yr), a surprising 27 (39%) cases of labral tear seen on high-resolution magnetic resonance (MR) imaging were reported.…”

“…Physiotherapy techniques currently include active and deep-tissue release in addition to progressive resisted stretching and strengthening activities. 1 Poor response to conservative treatment and increasing disability may require revisiting surgery as a treatment option.…”