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Labrum

Labrum: The Hip’s Protective Seal

The labrum is a vital structure that stabilizes the hip joint and maintains smooth movement. Damage to the labrum, whether from injury or structural issues, can compromise joint function and lead to pain. Discover the causes, symptoms, and innovative treatment options to preserve and restore hip health

Labral Function and Importance

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The labrum is a crucial component of the hip joint, which functions as a ball-and-socket system formed by the femoral head (ball) and acetabulum (socket). The labrum is a ring of fibrocartilage attached to the rim of the socket, creating a watertight seal around the ball. It serves two primary purposes: sealing the joint to maintain lubrication and stabilizing the hip by forming a suction seal around the femoral head. When the labrum is torn or detached, these functions are compromised, potentially leading to pain, instability, and early arthritis. Tears often occur due to repetitive injuries in conditions like femoroacetabular impingement (FAI) or hip dysplasia but can also result from trauma.

Labral Tears and Symptoms

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Many individuals discover labral tears incidentally during MRI scans performed for unrelated reasons. If a labral tear is asymptomatic or causes minimal pain, immediate surgical intervention may not be necessary. Instead, careful clinical evaluation determines if the tear correlates with symptoms. Patients with true asymptomatic tears can often resume activities as tolerated with periodic reevaluations, especially if underlying conditions like impingement or instability exist.

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Labral Repair

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Labral repair is the first-line treatment for a symptomatic torn labrum, particularly when conservative methods fail. This minimally invasive procedure involves reattaching the labrum to the rim of the acetabulum using bone anchors and sutures. Restoring the labrum’s suction seal improves hip stability and lubrication while reducing pain. Labral repair is often combined with procedures like reshaping the hip joint to address underlying issues such as FAI. By correcting both the tear and the structural abnormalities, this approach minimizes the risk of recurrence and provides long-term relief.

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​Labral Reconstruction

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In cases where the labrum is too damaged for repair—due to degeneration, calcification, or failed prior repairs—labral reconstruction may be performed. This involves replacing the damaged labrum with a tissue graft that mimics the native labrum in size, structure, and function. Performed arthroscopically, labral reconstruction effectively restores joint stability and function. However, to ensure lasting success, the procedure is typically paired with corrective measures for any structural abnormalities. Reconstruction offers an excellent alternative for patients with significant labral damage, promoting healing and reducing pain while preserving hip joint biomechanics.

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Treatment Approach

Managing a labral tear depends on the patient’s symptoms and the severity of any underlying structural abnormalities. Conservative options, including physical therapy, activity modification, anti-inflammatory medications, and platelet-rich plasma (PRP) injections, are recommended as initial steps. For patients with normal hip anatomy, these treatments often suffice. However, those with significant bony abnormalities or persistent symptoms may require surgical intervention.

In cases of symptomatic tears, minimally invasive hip arthroscopy allows for either labral repair or reconstruction. Patients with FAI or hip dysplasia often require additional procedures, such as joint reshaping or pelvic realignment (e.g., PAO or DFO), to address the root cause of the tear and prevent re-injury.

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Choosing the Right Treatment

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Not all labral tears require immediate surgical intervention. At Hip Preservation, we emphasize a personalized approach, treating the patient rather than focusing solely on imaging results. Surgery is only considered when it offers a significant likelihood of improving the patient’s condition and quality of life. Whether through conservative management, labral repair, or reconstruction, our goal is to restore function, relieve pain, and protect the hip joint for the future.

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