Hip Labral Disorders

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Clinically Relevant Anatomy

The labrum of the hip is responsible for deepening the acetabulum to provide increased joint stability. It contains nerve endings to enhance proprioception, but may also be a source of pain.

Mechanism of Injury / Pathological Process

The labrum is susceptible to traumatic injury from shearing forces that occur with twisting, pivoting and falling. The most common mechanism is an external rotation force in a hyperextended position.

Clinical Presentation

Symptoms may include pain, clicking, locking, catching, instability, giving way, and/or stiffness. A labral tear commonly refers pain to the anterior groin.

Labral tears have been classified into 4 types:
- radial flap: most common, disruption of free margin of the labrum
- radial fibrillated: fraying of the free margin, associated with degenerative joint disease
- longitudinal peripheral: least common
- abnormally mobile: can result from a detached labrum

Diagnostic Procedures

MRa is thought to be the diagnostic imaging of choice to evaluate an acetabular labral tear.

Outcome Measures

add links to outcome measures here (see Outcome Measures Database)

Management / Interventions

add text here relating to management approaches to the condition

Differential Diagnosis

Chondral lesion, osteoarthritis, hip dysplasia, Legg-Calve Perthes, Slipped Capital Femoral Epiphysis, trochanteric bursitis, psoas bursitis, stress fracture, lumbar radiculopathy, piriformis syndrome, avascular necrosis

Case Studies

Austin A, Meyer J, Powers C, Souza R. Identification of abnormal hip motion associated with acetabular labral pathology. J Orthop Sports Phys Ther. 2008;38(9):558-565.

References

Martin R, Enseki K, Draovitch P, Trapuzzano T, Philippon M. Acetabular labral tears of the hip: Examination and diagnostic challenges. J Orthop Sports Phys Ther. 2006:36(7):503-515.

Enseki K, Martin R, Draovitch P, Kelly B, Philippon M, Schenker M. The hip joint: Arthroscopic procedures and postoperative rehabilitation. J Orthop Sports Phys Ther. 2006;36(7):516-525.

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