The labrum is a protective layer of cartilage found in the ball and socket joint of the hip. It provides the relatively shallow hip joint with more stability, cushioning and a full range of motion. A tear in this cartilage, known as a labral tear, is often caused by either trauma to the hip or chronic overuse. These injuries are more common in individuals who play certain sports, such as golf or hockey, which require repetitive twisting or pivoting motions. In other cases, a tear may be the result of excessive wear on the labrum due to anatomical abnormalities in the structures of the hip joint. A labral tear can lead to pain, stiffness and a feeling of catching or clicking within the joint while moving.
To diagnose a labral tear, the physician will perform a physical examination and take a thorough medical history. It is frequently initially misdiagnosed since a labral tear has similar symptoms to a number of other physical problems. To confirm a suspected diagnosis, an injection of anesthesia may be administered to determine that the source of the pain is within the joint. Testing may include X-rays or an MRI scan to provide a precise view of the structures of the hip joint.
While some labral tears can be treated by managing pain symptoms with a combination of medication and physical therapy, many cases require surgical treatment. The goal of a labral debridement surgery is to trim back the torn area of the labrum in order to lower the risk of further tearing. The procedure can often be performed arthroscopically, using very small incisions and special surgical tools. This minimally invasive approach reduces trauma to the area and generally takes about one hour to complete.
After anesthesia is administered, the leg is placed in traction to open the hip joint to maximize access. The surgeon will make tiny incisions near the hip and insert the arthroscope and surgical tools. The arthroscope provides a clear view of the joint. The surgeon can then evaluate the labrum to selectively trim back the portion in which the tear has formed. Once the debridement is complete, the sutures are closed.
Labral debridement is a less extensive surgery than a labral repair procedure. Labral repair involves the implantation of anchors that must be drilled into the bone. In contrast, labral debridement focuses only on the shaving down of an area of the labrum and requires the use of no fixation devices. Both procedures have high success rates, reduce pain in the hip and improve the range of motion in the joint. The determination as to which procedure is better for each individual patient’s condition is dependent on the extent of the damage to the labrum and other factors.
After a labral debridement procedure, patients are typically able to return home the same day. There may be some residual pain as the joint heals, but this generally resolves on its own within a few weeks. An assistive device such as crutches or a cane may be needed in the short-term to avoid placing too much stress on the hip.
Labral debridement is considered a safe procedure, but as with all forms of surgery, it does carry some risk. The risks associated with labral debridement may include damage to the cartilage of the hip, nerve injury and swelling around the treatment site.