The labrum is a protective layer of cartilage in the hip joint. It provides this relatively shallow ball-and-socket joint with more stability and cushioning, allowing for a full range of motion. Tears in this cartilage, known as labral tears, are often caused by either trauma to the hip or chronic overuse. Such injuries are more common in individuals who play sports which require repetitive twisting or pivoting motions, such as golf or hockey. Tears of this type may also be the result of excessive wear on the labrum due to anatomical abnormalities. Labral tears can lead to pain, stiffness and a catch or click within the joint during movement.
Diagnosis of a Labral Tear
To diagnose a labral tear, the physician will perform a physical examination and take a thorough medical history. Labral tears are frequently misdiagnosed because their symptoms are similar to those of a number of other ailments or conditions. To confirm a suspected diagnosis, an injection of anesthesia may be administered to help pinpoint the area in which the pain originates. Testing may include X-rays or an MRI scan to provide a precise view of the internal structures of the hip joint.
The Labral Debridement Procedure
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 procedure is to trim back the torn area of the labrum in order to lower the risk of further tearing. The procedure is often 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 maximize access to the hip joint. The surgeon makes tiny incisions near the hip and inserts the arthroscope and surgical tools. The arthroscope provides a clear view of the joint so the surgeon can precisely evaluate which portion of the labrum to trim back. Once the debridement is complete, the incisions are closed with sutures.
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 several factors, primarily the extent of the damage.
Risks of a Labral Debridement
Labral debridement is considered a safe procedure, but, as with all forms of surgery, it does carry some risks. The risks associated with labral debridement may include damage to the cartilage of the hip, nerve injury and swelling around the treatment site.
Recovery from a Labral Debridement
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. Patients may need assistive devices such as a walker, crutches or a cane temporarily to avoid placing too much weight on the hip as it heals.