The labrum is a smooth ring of fibrocartilage which lines the hip socket, deepening it and acting as a seal for the head of the femur. The function of the labrum is shock absorption, pressure distribution, joint lubrication and hip stability. A tear in the hip labrum commonly occurs in sports such as soccer, ice hockey, golf and ballet. Pain in the hip or groin, weakness, stiffness and clicking or catching may be felt when the labrum is damaged.
Causes of labral tears
Hip labral tears can be caused by:
- Trauma – injury or dislocation of the hip joint. For example, during motor vehicle accidents or contact sports
- Congenital abnormalities – structural changes of the hip joint from birth may accelerate wear and tear of the labrum
- Overuse injuries – repetitive twisting or pivoting on the hip joint during physical activity or sports, such as golf
When there is significant damage to the hip labrum, the stabilising function is compromised which may lead to hypermobility of the joint, predisposing it to degeneration and osteoarthritis in the future.
Traditional approaches to treatment are often unsuccessful because the labrum has a poor blood supply. Pain medication, rest and physiotherapy does little to repair the labrum and therefore, patients are often referred for surgery. However, surgery does not always guarantee successful return to function, especially when the labrum is debrided. During a debridement, part of the labrum is removed, compromising its function. This means that the stresses and strains within the joint will increase, and its stability will decrease.
Dr Ross Hauser points out that research of patients 45 years or older, who had arthoscopic labral surgery have a relatively high re-operation rate and minimal overall improvement with small clinical benefit.
Comprehensive Prolotherapy is an excellent alternative to surgery for hip labral tears. Prolotherapy is an injection technique which causes an inflammatory process to start at the injection site. This causes cell proliferation and remodeling of damaged tissues, leading to healing. It is through this mechanism that the stability of the joint is restored and chronic pain is alleviated. It also prevents the development of future degeneration and osteoarthritis of the joint.