Hip Labral Tear Symptoms

Hip labral tear (acetabular labral tear)  patients usually appear with mechanical symptoms (locking,catching and painful clicking) as well as restricted range of motion. Stiffness in the joint can also be seen.

This is kind of a silence disease. Thus there are no obvious symptoms other than pain and mentioned symptoms above.  Pain is the major symptom of this disease where the labral tear usually locks the hip. Patient may experience a significant pain.  However in some occasions there may be no pain symptoms. Some patients apply with aching symptoms within the inner hip or groin region.

Patients usually apply to physicians with following complaints:

• I don’t have good flexibility in my hip
• It hurts to externally rotate my hip
• I  have a terrible pain that woke me up at night
• I have a lower back pain and buttock pain
• I have a terrible pain in my right hip
• My pain is increasing during a physical activity
• I am experiencing a pain in the trochanteric region
• My pain is so bad that after a running for a while, I can’t walk home easily
• I have a terrible pain when I sit, bend and twist
• I have a severe groin pain
• I can’t easily lift my leg
• My pain is increasing when I run through the hills
• I am having a lot of pain down the front of the thigh during any kind of impact activity, even walking
• I am having hip, pelvis, knee and spine pain
• I have been experiencing a limited activity for this month

Labral tears do not show up on an x-ray. Thus after taking the patient’s disease history and careful physical examination with the help of MRI (MR) physicians can diagnose the disease. To eliminate misdiagnose MR is necessary.

Hip arthroscopy is a very common diagnostic and therapeutic tool; popularity of arthroscopy is very high among orthopaedicians. With the help of advanced research and development efforts in this field; today physicians even have more alternative diagnostic choices including MRI (magnetic resonance imaging) and intraarticular hip pathology.

The evolution of the technologies in below areas provided improved accessibility of the hip joint and ensured a more detailed understanding of specific intraarticular soft tissue lesions, notably hip labral tears including:

• Patient set up
• Needle positioning
• The right portal placement
• Surgical techniques
• Arthroscopic instruments
• Distraction techniques

Diagnosis is an important issue for patients with hip labral tear; remembering that it is clinical and is analogous to those patients who has meniscal pathology. This particular patient population has mechanical symptoms together with restricted range of motion.

Mechanical symptoms include painful clicking, catching and etc.. From time to time the presence of mechanical symptoms are more quiet with signs and symptoms of dull, activity induced and  particular positional pain which fails to be in a better clinical condition with rest.

It has been observed that misdiagnosing takes place especially while observing the clicking symptoms; where this symptom is being confused with hip labral tear knowing that the etiology is completely different.

Please find below the steps for a proper diagnosing hip labral tears:

• Patient history
• Physical examination
• Appropriate diagnostic imaging
• MR (non-contrast methods or gadolinium enhanced methods)
• Radiographs

Managing patients with hip labral tear through Arthroscopy includes repair and debridement. The main objective of  debridement of a torn hip labrum is to manage pain by discarding the unstable flap tear that causes the inspected hip problem.
Various surgical techniques are applied to patients with hip labral tear; this merely depends on the nature of the labral injury.

Mainly there are 2 major types of acetabular labrum tears:

•    Type I
•    Type II

Type I  of acetabular labrum tears  represent a disengagement of the labrum at transition area to the articular hyaline cartilage and require reattachment to the acetabular rim, generally with anchor.

Type II of acetabular labrum tears are intrasubstance splits with one or more cleavage planes can be repaired with a suture lasso technique and a bioabsorbable suture.