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Hip Labral Tears

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A hip labral tear is a relatively common pathology. It is linked to the condition of Femoroacetabular Impingement, but may also exist on its own. The Labrum is a soft tissue structure that runs around the acetabular rim, and acts to hold joint fluid in, and act to increase the “negative pressure” of the joint, helping with stability. When it is torn, it can cause groin pain, often experienced in athletes who participate in kicking, lunging and cross body activities such as Football, Netball, and Dancing. Groin pain is the usual symptoms, with minimal symptoms when walking on flat ground, unless there is associated joint inflammation (synovitis).

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The image on the left shows the anatomy of the hip labrum and what a tear involves. Symptoms may involve. :

  • Joint Stiffness
  • Difficulty sprinting
  • Pain when kicking a football
  • Pinching sensation in the hip when reaching for your toes
  • A limp.

Once a labral tear is suspected, then an MRI is the most beneficial investigation as it can show the severity of it all.

Non operative management options for a hip labral tear are limited. Depending on the severity of the labral tear, several things can be done. If the labrum is damaged severely, then often non operative management will not be successful. For small tears, and pain due to inflammation of the joint, the following can be attempted first.

  1. Regular Panadol Osteo – This is the same as regular Panadol (Paracetamol) however the dose per tablet is slightly higher. This means that you should only take up to a maximum of 6 tablets per day rather than the usual 8 for Panadol.
  2. Glucosamine and Fish Oil – A large study performed in the USA found that there was a benefit in approximately 2/3rds of patients suffering from pain from osteoarthritis of the knee or hip (which may help with pain from a labral tear). This helped to reduce the perceived pain. Glucosamine and Fish oil act as a natural anti-inflammatory and can be a great supplement to your usual medications as the risks are comparatively low. Fish oil has other beneficial effects for the rest of the your body, not just your joints. These agents will never repair cartilage, but can act to prevent inflammation which can be harmful to a joint.
  3. Anti-inflammatory medication – Taken in short spurts, this can be a safe and effective method to reduce pain. Anti-inflammatory medication can interact with other medications, so ensure that you check with your doctor first. You should only take this sort of medication on a short burst regimen. A few days on and then a few days off.
  4. Avoidance of the sporting activity for a period of time
  5. If suitable, a local anaesthetic and steroid injection into the joint under ultrasound guidance. This can remove the inflammatory portion within the joint and allow a return to sport, however does not alter the labral tear in any way.

Hip Arthroscopic surgery

Minimally invasive surgery to the hip

Fast Recovery, Minimal Pain

There are no post operative movement restrictions immediately after your operation.

Return to sport

Return to sport gradually from 6-8 weeks post op.

Operative Treatment

When an operation is contemplated, there are two main options. Open and Arthroscopic. Arthroscopic surgery is minimally invasive as no muscles are cut, and bone is not cut to access the hip joint. The recovery is generally rapid, and 90% of the hip joint can be viewed using special angled cameras during the operation.

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A hip arthroscopy is a specialised operation, requiring a special operating table, and instruments that enable the hip to be operated on without damage to the joint itself. Labral repairs and clean ups can be performed this way, along with shaving of any abnormal bone in the hip.

Orthopaedics 360

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Orthopaedics 360

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