The labrum is cartilage in the hip that lines the outer lip of the socket (acetabulum). It acts as a bumper for the joint and creates a suction seal for the hip socket to provide stability within the hip joint. Damage to the labrum can result in damage to the articular cartilage, which is the lining that covers the ball and the socket of the hip.
Patients with a labrum tear often have a history of femoroacetabular impingement. Labrum injuries can also occur traumatically when there is a shear force across the hip, as in a car accident.
Patients with a labrum injury experience a variety of symptoms, including deep groin pain, decreased range of motion of the hip, occasional sharp anterior hip pain, and sometimes a snapping or popping sensation in the hip. Frequently there is a catching sensation in the hip, pain when sitting for prolonged periods of time, pain with exercising and with hyperflexion of the hip, as well as lower back pain, buttock pain, and hip stiffness.
In order to diagnosis a labrum injury, a thorough history and physical exam are performed. Plain X-ray films will be performed to determine the shape of the ball and socket and assess the amount of joint space in the hip, which will help evaluate for osteoarthritis and FAI (femoroacetabular impingement). In addition, an MRI (magnetic resonance imaging) with injection of dye (gadolinium) into the hip joint is necessary to identify labrum tears.
Treatment of labrum tears is multifaceted and usually involves a combination of NSAIDs (non-steroidal anti-inflammatories, such as ibuprofen, Advil, Aleve, etc.) and extensive physical therapy that focuses on improving flexibility and strengthening hip musculature. In order to prevent further cartilage injury and damage to the labrum, patients are advised to avoid heavy impact on the hips and repetitive deep flexion exercises, such as squats and lunges, especially in the face of FAI.
If conservative treatment fails, patients may require arthroscopic hip surgery to repair the frayed or torn labrum and correct any signs of FAI, such as a misshapen ball and socket of the hip.