Labral Tear
Acetabular labral tear causes pain if the labrum is frayed, torn, or damaged. Labral tears can result in pain in the anterior side of the hip, groin pain, and buttock pain. This condition is thought to result from excessive force at the hip joint.
For instance, a tear may decrease the acetabular contact area increasing stress. This may destabilize the hip joint by causing articular damage. Labral tears can be classified as:
- Posterior labral tears: these are situated deep in the posterior buttocks or in the lateral region.
- Anterior labral tears: the pain may become more consistent in this type of tear. It is situated at the groin, anterosuperior quadrant, or on the anterior hip. These are more common in United States individuals.
Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, Beverly Hills, CA, and surrounding communities.
Clinically Relevant Anatomy
The acetabular labrum comprises of the fibro-cartilaginous rim. This encompasses the circumference of the acetabulum and helps in keeping the femoral bone’s head inside the acetabulum. The labrum differs widely in form and thickness.
There are three surfaces to the labrum:
- Internal articular surface is adjacent to the joint
- External articular surface is in contact with the joint capsule
- Basal surface is attached to the acetabular ligaments and bone
The labrum is triangular in the radial section on the anterior aspect. It is dimensionally square with a rounded distal surface on the posterior aspect.
Various functions of the acetabular labrum include:
- Sensitive shock absorber
- Joint lubricator
- Pressure distributor
- Joint stability
- Decreasing contact stress between the femoral and acetabular cartilage
Epidemiology/Etiology
Labral tear injuries are attributed to several causes by researchers studying patients:
- Direct trauma includes falling with or without dislocation, slipping, and motor accidents among others
- Sporting activities requiring hyperextension or frequent external rotations, such as soccer, ballet, running, hockey, and sprinting
- Specific movements include twisting movements, torsional movements, hyperextension, hyper abduction, and hyperextension with lateral rotation
This is not an age-related condition and can occur in anyone from 8 – 75 years of age.
Arthroscopy
Acetabular labral lesion repair can be performed in both lateral and supine position. A stand fracture table is used when patients are treated in the supine position. Traction is applied by keeping the patients in an oversized perinal post.
The affected hip will be slightly extended to approach the joint. There should be minimized pressure on the perineal area during traction for avoiding neurological complication. The procedure is performed under the guidance of fluoroscopy.
Tear edges are delineated and suture anchors placed on the acetabular rim for repairing a detached labrum. A suture is placed in the mid-substance of the tear if the labrum tear has a secure outer rim. This suture is placed in cases where the labrum is still attached to the acetabulum. It is done for securing the tear.
Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, receives patients from Los Angeles, Century City, Beverly Hills, CA, and nearby areas for orthopedic surgery.
Contact the Southern California Hip Institute
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:
Century City / Los Angeles: 310.595.1030
Serving patients in Los Angeles, Beverly Hills, Santa Monica, Century City, West Hollywood, North Hollywood Encino, Sherman Oaks, Van Nuys, Burbank, Glendale and other neighboring cities in the greater Los Angeles, California area.
Also visit http://www.drgorthopedics.com/
