Hip
Hip Labral Tear
고관절 관절와순 파열
Tear of the acetabular labrum causing groin pain and hip instability
- How common
- Uncommon
- Typical age
- Ages 20–50
What is it?
The acetabular labrum is a fibrocartilaginous structure attached to the acetabular rim; tear causes joint instability and pain
Commonly affected: Acetabular labrum, articular cartilage, femoroacetabular joint
How it develops
- FAI (Femoroacetabular Impingement)Cam-type (femoral head deformity) or Pincer-type (acetabular overcoverage) impingement damages labrum
- Labral DamageRepetitive impingement causes fibrocartilage injury and tear
- Pain and InstabilityLoss of joint sealing function, increased joint instability
- Progressive Chondral DamageUntreated labral tear progresses to cartilage damage and OA
Symptoms
- Impingement PainSharp anterior groin pain with hip flexion-internal rotation-adduction
- C-SignPatient grasps groin in C-shape — specific behavioral sign for labral tear
- Clicking/LockingClicking, popping, or locking sensation during hip movement
- Endurance LimitationPain worsens with prolonged sitting, walking, sports
How it is examined
- FADIR TestFlexion, ADduction, Internal Rotation elicits groin pain → sensitive for labral tear and FAI
- FABER TestPositive when groin pain (not lateral) is reproduced — may also be positive in OA
- Resisted Flexion TestPain or weakness with resisted hip flexion in seated position
- C-Sign ObservationObserve patient spontaneously grasping groin in C-shape
Imaging
Pelvis AP X-ray to assess FAI morphology (alpha angle measurement)
- Cam type: femoral head-neck junction asphericity (alpha angle >55°)
- Pincer type: acetabular overcoverage, rim ossification
- Joint space normal in early stages
MR arthrography is the gold standard for labral tear diagnosis
- Contrast penetrating into labrum (tear sign)
- Labral thickening and deformity
- Associated chondral defect
- Paralabral cyst
Non-surgical care
- Activity ModificationAvoid impingement-provoking positions (deep flexion, adduction, IR)
- Physical TherapyHip stabilizer strengthening, corrective gait retraining
- Intra-articular InjectionUltrasound-guided hyaluronic acid or PRP injection for symptom relief
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Failed conservative treatment 3-6 months, arthroscopically confirmed labral tear
Procedures that may be discussed
- Arthroscopic labral repair — first choice
- Arthroscopic cam/pincer osteoplasty
- Labral reconstruction — when repair not possible
Outlook
70-85% pain reduction and functional recovery after arthroscopic repair. Concurrent chondral damage affects prognosis