Update on contribution of hip labral tears to hip pain: A narrative review

Berthelot, Jean‐Marie; Brulefert, Kévin; Arnolfo, Paul; Goff, Benoît Le; Darrieutort-Laffite, Christelle

doi:10.1016/j.jbspin.2022.105465

Cited by 4 publications

(4 citation statements)

References 56 publications

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“…This may lead to failure of the LT as a secondary restraint on femoral head motion, further exacerbating the potential magnitude of femoral head translation during these movements and increasing the opportunity of osteochondral damage and perception of pain. 53,54 Together, this evidence suggests that a hockey athlete with cam morphology is likely to exhibit an increased risk of a labrum tear due to the repetitive forward skating mechanics combined with femoral head asphericity. If a labrum tear occurs, there will be an increased reliance on the IFL, LT and capsule to provide passive stabilization to the hip, thereby increasing the strain on and risk of subsequent failure of these tissues.…”

Section: Repetitive Skating Mechanics and Intra-articular Hip Injuriesmentioning

confidence: 96%

“…52 As the anterior labrum, IFL and LT contain a large distribution of mechanoreceptors and nociceptors, they are crucial structures for hip joint proprioception and stability, and also highly efficient in transmitting pain signals to the central nervous system (CNS). 39,54 Therefore, damage to the labrum, and potential IFL and LT lengthening, will likely compromise the feedback loop to the CNS, resulting in poor hip joint proprioception, reduced passive and active stability and exacerbated femoral head translation. Together, this will likely increase tissue irritation, inflammation, and pain in the labrum, IFL and LT, as well as potential osteochondral damage.…”

Section: Femoral Head Translation and Painmentioning

confidence: 99%

“…Together, this will likely increase tissue irritation, inflammation, and pain in the labrum, IFL and LT, as well as potential osteochondral damage. 54 Importantly, it has been identified that bony hip deformities, joint capsule laxity, and muscle dysfunction or imbalance are likely to exacerbate the strain on the anterior hip joint. 41,55 As such, a large proportion of hip and groin pain experienced by hockey athletes may be due to a constant cycle of poor mechanoreceptor feedback from a torn labrum, lengthened IFL or LT, and inadequate feedforward adjustments from the stabilizing muscles of the hip, resulting from hip microinstability.…”

Section: Femoral Head Translation and Painmentioning

confidence: 99%

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Associations Between Hip Pathology, Hip and Groin Pain, and Injuries in Hockey Athletes: A Clinical Commentary

Kelly,

Secomb

2024

International Journal of Sports Physical Therapy

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Femoroacetabular impingement (FAI), particularly cam morphology, is highly prevalent among elite hockey athletes. Moreover, hip and groin pain has become a common issue in hockey, with approximately 50% of European professional athletes reported to experience a hip or groin problem during a season. While most athletes will not miss training or competition due to this, restricted competitive performance and increased risk of reduced physical and psychological well-being are likely. Recent research suggests that the development of cam morphology is related to the repetitive shear stresses experienced at the hip joint during adolescence from skating. This condition likely increases the potential for intra-articular and extra-articular injuries in these athletes later in their careers. Research also indicates that the hip joint mechanics during forward skating substantially increase the possibility of sustaining a labral tear compared to other sports. Such an injury can increase femoral head movement within the joint, potentially causing secondary damage to the iliofemoral ligament, ligamentum teres and joint capsule. These injuries and the high density of nociceptors in the affected structures may explain the high prevalence of hip and groin pain in hockey athletes. Compensatory adaptations, such as reduced hip strength, stability, and range-of-motion (ROM) likely increase the opportunity for core muscle injuries and hip flexor and adductor injuries. Specifically, the limited hip ROM associated with cam morphology appears to exacerbate the risk of these injuries as there will be an increase in pubic symphysis stress and transverse strain during rotational movements. It is hoped that this article will assist practitioners currently working with hockey athletes to develop evidence-informed monitoring strategies and training interventions, aimed at reducing the incidence and severity of hip and groin problems, ultimately enhancing athlete performance and well-being. Therefore, the purpose of this clinical commentary was to examine current evidence on common hip pathologies in hockey athletes, exploring potential associations between hip and groin pain and the biomechanics of hockey activities. Level of Evidence 5

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Section: Repetitive Skating Mechanics and Intra-articular Hip Injuriesmentioning

confidence: 96%

Section: Femoral Head Translation and Painmentioning

confidence: 99%

Section: Femoral Head Translation and Painmentioning

confidence: 99%

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Associations Between Hip Pathology, Hip and Groin Pain, and Injuries in Hockey Athletes: A Clinical Commentary

Kelly,

Secomb

2024

International Journal of Sports Physical Therapy

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“…Acetabular labral tears are a commonly identified in young and middle‐aged patients and are among the most common pathology addressed in patients undergoing hip arthroscopy [1, 6, 25]. However, studies have documented a high rate of asymptomatic labral tears in adults, ranging between 69 and 85% [24, 27].…”

Section: Introductionmentioning

confidence: 99%

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Pullen

Curtis

Jamero

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this paper was to evaluate the response to intra-articular hip injections with and without concurrent gadolinium administration. Our secondary outcome was to compare post-operative outcomes between patients with an initial false-negative gadolinium-containing injection and a matched control group. Methods Patients receiving a series of two hip diagnostic intra-articular injections (DIAI), the irst with gadolinium for concurrent MRA and the second without gadolinium, were retrospectively identiied. Pain response to DIAI, injectate volume, local anesthetic volume, inclusion of corticosteroids, and method of injection were compared between injections. False-negative injection was deined as < 50% pain relief with concurrent gadolinium, but ≥ 50% pain relief with subsequent anesthetic injection without gadolinium. False-negative injections in patients that ultimately underwent primary hip arthroscopy were identiied from this cohort and matched in a 3:1 ratio to a control cohort to compare short-term post-operative single assessment numerical evaluation (SANE) outcomes. Results Forty-three patients underwent a series of anesthetic injections with and without gadolinium and met inclusion and exclusion criteria. Pain response was signiicantly diferent in injections performed with and without gadolinium (18% vs. 81%; p < 0.001). There were signiicant diferences in total injectate volume, local anesthetic volume, corticosteroid use, and method of injection between injections, but these variables were not correlated with pain response. Fifteen patients with false-negative responses to injection underwent primary hip arthroscopy and were matched in a 3:1 ratio to a control cohort. There was no diference in short-term post-operative SANE scores between the gadolinium-sensitive and control groups (81.6 vs. 80.0, n.s.). Conclusion Concurrent administration of intra-articular gadolinium with DIAI may result in a false-negative response to anesthetic. Additionally, in patients with initial false-negative DIAI with gadolinium, short-term post-operative outcomes after hip arthroscopy are similar to a matched cohort. Level of Evidence Level III.

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Decreased Hip Labral Width Measured on Preoperative Magnetic Resonance Imaging Is Associated With Greater Revision Rate After Primary Arthroscopic Labral Repair for Femoroacetabular Impingement Syndrome at 5-Year Follow-Up

Li,

Shankar,

Vasavada

et al. 2024

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Update on contribution of hip labral tears to hip pain: A narrative review

Cited by 4 publications

References 56 publications

Associations Between Hip Pathology, Hip and Groin Pain, and Injuries in Hockey Athletes: A Clinical Commentary

Associations Between Hip Pathology, Hip and Groin Pain, and Injuries in Hockey Athletes: A Clinical Commentary

Gadolinium injected concurrently with anesthetic can result in false-negative diagnostic intra-articular hip injections

Decreased Hip Labral Width Measured on Preoperative Magnetic Resonance Imaging Is Associated With Greater Revision Rate After Primary Arthroscopic Labral Repair for Femoroacetabular Impingement Syndrome at 5-Year Follow-Up

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