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The hip labrum is a ring of tough fibrocartilage that supports the acetabulofemoral joint (the ball-and-socket joint between the hip and femur). When the hip labrum becomes injured, it can lead to hip instability, abnormal rubbing of bones, cartilage degeneration, and predisposes the individual to hip osteoarthritis (OA).
Labral tears are more common than one would expect, affecting 22-55% of patients with reported hip or groin pain (1). Both younger and older individuals can suffer from a labral tear, which can be taxing on quality of life.
The labrum has many functions in the hip joint. It serves as a cushion that absorbs shock from movement and deepens the socket that holds the head of the femur in-place. It allows the femur to glide smoothly during locomotion by preventing the bones involved from rubbing against each other. The labrum also provides stability by sealing the head of the femur (ball) into the acetabulum (socket) of the hip.
Hip Labral Tear
A hip labral tear interferes with the normal function of the acetabulofemoral joint and hip stability. This can lead to stiffness, limited range of motion, soreness, and pain of the joint itself as well as compensatory muscle action from uneven weight distribution. An unstable joint with abnormal friction between bones degenerates cartilage and sets the stage for arthritis and femoroacetatabular impingement (FAI).
A hip injury can interfere with activities of daily life and can cause disability. Individuals with a hip labral tear may experience:
- Pain in the groin or buttocks
- Pain while bending, walking, sitting or standing
- Clicking or locking sounds while moving the hip
- Discomfort exercising or playing a sport
- No symptoms
Hip labral tears can happen as a result of acute trauma or repetitive motions over time (gradual wear and tear). Hip instability from other soft tissue injuries like tendons and ligaments can alter hip mechanics and predispose an individual to a labral tear. Congenital structural abnormalities of the hip may also be a risk factor. Conventional Treatments
Conventional treatments for hip labral tear include physical therapy to strengthen muscles of the hip and leg that support the acetabulofemoral joint and pain management.
This may include over the counter medications like non-steroidal anti-inflammatory drugs (NSAIDS), and cortisone injection to manage pain and reduce swelling. Unfortunately, pain medications that oppose inflammation are counterintuitive, they interfere with inflammation which is part of the healing process. Soft tissues such as the labrum are also known for their limited blood supply which is yet another barrier in healing. Soft tissues tend to heal incompletely for this reason, and progressively worsen until invasive procedures become necessary.
Prolotherapy is ideal for repairing soft tissue injuries such as a hip labral tear. It involves injecting a proliferative substance -a substance that grows new tissue- to the affected area to elicit its repair. This not only amplifies the healing process but restores joint stability and function, haling the degenerative process. Repairing the joint and restoring stability treats the pain symptoms while allowing the patient to return to normal daily life or athletic activity.
Grah, M. M., & Herrera, J. (2009, April 7). A comprehensive review of hip labral tears | Request PDF. Retrieved from https://www.researchgate.net/publication/26240389_A_comprehensive_review_of_hip_labral_tears
Hip Labral Tear: Symptoms, Causes, Treatments. (n.d.). Retrieved from https://my.clevelandclinic.org/health/diseases/17756-hip-labral-tear