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A comprehensive review of hip labral tears.

Groh MM, Herrera J - Curr Rev Musculoskelet Med (2009)

Bottom Line: The hip labrum has many functions, including shock absorption, joint lubrication, pressure distribution, and aiding in stability, with damage to the labrum associated with osteoarthritis.Typically, treatment begins conservatively with relative rest and non-steroid anti-inflammatory agents, with physical therapy (PT) being controversial.Often, surgical treatment is necessary, which entails, arthroscopic debridement of labral tears and surgical repair of associated structural problems.

View Article: PubMed Central - PubMed

Affiliation: Physical Medicine & Rehabilitation, Mount Sinai Hospital, New York, NY, USA. yankegirl8@yahoo.com

ABSTRACT
The hip labrum has many functions, including shock absorption, joint lubrication, pressure distribution, and aiding in stability, with damage to the labrum associated with osteoarthritis. The etiology of labral tears includes trauma, femoroacetabular impingement (FAI), capsular laxity/hip hypermobility, dysplasia, and degeneration. Labral tears present with anterior hip or groin pain, and less commonly buttock pain. Frequently, there are also mechanical symptoms including clicking, locking, and giving way. The most consistent physical examination finding is a positive anterior hip impingement test. Because of the vast differential diagnosis and the need for specialized diagnostic tools, labral tears frequently go undiagnosed during an extended period of time. Evaluation usually begins with plain radiographs to assess for dysplasia, degeneration, and other causes of pain. While magnetic resonance imaging (MRI) and computed tomography scans are unreliable for diagnosis, magnetic resonance arthrography (MRA) is the diagnostic test of choice, with arthroscopy being the gold standard. Typically, treatment begins conservatively with relative rest and non-steroid anti-inflammatory agents, with physical therapy (PT) being controversial. Often, surgical treatment is necessary, which entails, arthroscopic debridement of labral tears and surgical repair of associated structural problems.

No MeSH data available.


Related in: MedlinePlus

Photograph demonstrating anatomy of labrum with respect to hip joint. Courtesy of Ithaca College Department of Physical Therapy website (http://www.ithaca.edu/faculty/lahr/LE2000/hip%20pics/8acetabularlig.jpg)
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Fig1: Photograph demonstrating anatomy of labrum with respect to hip joint. Courtesy of Ithaca College Department of Physical Therapy website (http://www.ithaca.edu/faculty/lahr/LE2000/hip%20pics/8acetabularlig.jpg)

Mentions: The hip joint is a ball-and-socket joint enveloped in dense capsular tissue [11]. The Y-shaped triradiate cartilage acetabulum covers 170° of the femoral head.[11, 12]. The acetabular labrum is a fibrocartilaginous structure that outlines the acetabular socket [11] (Fig. 1). It is a continuous, usually triangular structure that attaches to the boney rim of the acetabulum and is completed at the inferior portion by the transverse acetabular ligament over the acetabular notch [7, 13–15]. Other variants of the normal triangular shape, including round, irregular, and flattened, have been noted in people without hip pain [7, 16–21]. The incidence of triangular labra decreases with increasing age, whereas the incidence of rounded and irregular margins increases with age [17, 20, 21]. The labrum attaches directly to the nonarticular side of the thin bony rim of the acetabulum and on the articular side, and indirectly through a zone of calcified cartilage and by merging with the acetabular articular hyaline cartilage through a transition zone of 1–2 mm [7, 15]. The thickness of the labrum may slightly vary, but it is from 2 to 3 mm thick [11]. The labrum is wider and thinner in the anterior region and thicker in the posterior region [7, 13, 15, 22–25]. The posterior labrum has a sulcus that can be mistaken for pathology, which will be further described in the evaluation section [11].Fig. 1


A comprehensive review of hip labral tears.

Groh MM, Herrera J - Curr Rev Musculoskelet Med (2009)

Photograph demonstrating anatomy of labrum with respect to hip joint. Courtesy of Ithaca College Department of Physical Therapy website (http://www.ithaca.edu/faculty/lahr/LE2000/hip%20pics/8acetabularlig.jpg)
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2697339&req=5

Fig1: Photograph demonstrating anatomy of labrum with respect to hip joint. Courtesy of Ithaca College Department of Physical Therapy website (http://www.ithaca.edu/faculty/lahr/LE2000/hip%20pics/8acetabularlig.jpg)
Mentions: The hip joint is a ball-and-socket joint enveloped in dense capsular tissue [11]. The Y-shaped triradiate cartilage acetabulum covers 170° of the femoral head.[11, 12]. The acetabular labrum is a fibrocartilaginous structure that outlines the acetabular socket [11] (Fig. 1). It is a continuous, usually triangular structure that attaches to the boney rim of the acetabulum and is completed at the inferior portion by the transverse acetabular ligament over the acetabular notch [7, 13–15]. Other variants of the normal triangular shape, including round, irregular, and flattened, have been noted in people without hip pain [7, 16–21]. The incidence of triangular labra decreases with increasing age, whereas the incidence of rounded and irregular margins increases with age [17, 20, 21]. The labrum attaches directly to the nonarticular side of the thin bony rim of the acetabulum and on the articular side, and indirectly through a zone of calcified cartilage and by merging with the acetabular articular hyaline cartilage through a transition zone of 1–2 mm [7, 15]. The thickness of the labrum may slightly vary, but it is from 2 to 3 mm thick [11]. The labrum is wider and thinner in the anterior region and thicker in the posterior region [7, 13, 15, 22–25]. The posterior labrum has a sulcus that can be mistaken for pathology, which will be further described in the evaluation section [11].Fig. 1

Bottom Line: The hip labrum has many functions, including shock absorption, joint lubrication, pressure distribution, and aiding in stability, with damage to the labrum associated with osteoarthritis.Typically, treatment begins conservatively with relative rest and non-steroid anti-inflammatory agents, with physical therapy (PT) being controversial.Often, surgical treatment is necessary, which entails, arthroscopic debridement of labral tears and surgical repair of associated structural problems.

View Article: PubMed Central - PubMed

Affiliation: Physical Medicine & Rehabilitation, Mount Sinai Hospital, New York, NY, USA. yankegirl8@yahoo.com

ABSTRACT
The hip labrum has many functions, including shock absorption, joint lubrication, pressure distribution, and aiding in stability, with damage to the labrum associated with osteoarthritis. The etiology of labral tears includes trauma, femoroacetabular impingement (FAI), capsular laxity/hip hypermobility, dysplasia, and degeneration. Labral tears present with anterior hip or groin pain, and less commonly buttock pain. Frequently, there are also mechanical symptoms including clicking, locking, and giving way. The most consistent physical examination finding is a positive anterior hip impingement test. Because of the vast differential diagnosis and the need for specialized diagnostic tools, labral tears frequently go undiagnosed during an extended period of time. Evaluation usually begins with plain radiographs to assess for dysplasia, degeneration, and other causes of pain. While magnetic resonance imaging (MRI) and computed tomography scans are unreliable for diagnosis, magnetic resonance arthrography (MRA) is the diagnostic test of choice, with arthroscopy being the gold standard. Typically, treatment begins conservatively with relative rest and non-steroid anti-inflammatory agents, with physical therapy (PT) being controversial. Often, surgical treatment is necessary, which entails, arthroscopic debridement of labral tears and surgical repair of associated structural problems.

No MeSH data available.


Related in: MedlinePlus