Knee Replacement Surgery| PJS Orthopaedics Melbourne

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ACETABULAR LABRAL TEARS SYMPTOMS, CAUSES,
TREATMENTS PJS ORTHOPAEDICS
What is a labrum? The labrum is a soft tissue
structure located around the edge of the hip
socket (acetabulum). The hip labrum plays an
important role in providing hip stability,
proprioception (ability to sense position and
motion), the distribution of hip forces and joint
lubrication Risk factors for labral tears Risk
factors for labral tears include repetitive
movements such as deep flexion and or rotation
of the hip. Abnormal hip shape (cam, pincer and
dysplasia) can predispose patient to labral
tears Typically occur in from late teenage
years, young adults participating in sports
through to adulthood. High risk sports for
labral tears The common sports include
Australian Football, gymnastics, dancing, marital
arts, water polo, hockey, power lifting, wicket
keeper playing cricket and Yoga. Mechanism of
injury The mechanism of injury can include a
twisting, pivoting, excessive movement /
stretching of the hip (flexion abduction external
rotation. Flexion adduction and internal
rotation), repetitive deep squatting or lunging.
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In the presence of abnormal shape (cam, pincer
and dysplasia), a labral tear can occur even
more easily with these movements. In particular,
in the presence of cam or pincer impingement,
abnormal / premature abutment occurs with the
acetabular labrum predisposing to a labral
tear. What happens if you do not treat the
symptomatic labral tears? Labral tears can
significantly reduce hip stability, putting more
stress in the hip muscles and hip
cartilage. Untreated symptomatic labral tears
left untreated can contribute to the progression
of cartilage damage and premature osteoarthritis
of the hip joint. What are the symptoms of a
labral tear? Labral tears are frequently located
at the front of the hip joint (acetabulum,
socket) and cause groin, lateral hip and or deep
buttock pain. The symptoms can often fluctuate
in severity, varying in intensity. The pain can
be aggravated by prolonged sitting, standing,
walking, sleeping, running and or twisting.
Occasionally some but not all patients may
develop intermittent instability or weakness in
their hip strength. This is often despite
physiotherapy. Due to the presence of hip
instability, the hip muscles often become tight
and tender due to them compensative for the lack
of hip stability. Massage / releasing the tight
muscles with a foam roller often only provide
temporary relief only. How to diagnosis labral
tear of the hip?
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A 3 telsa MRI scan is an accurate way of
diagnosing a labral tear. The scan must be used
in combination with a clinical assessment to
determine the significance of the labral
tear. Management of a hip labral tear The
management of a symptomatic hip labral tear will
need a thorough assessment of the history,
examination and MRI scan of the hip. If the hip
continues to cause pain in the groin, lateral hip
and or buttock despite a trial of 3 months
conservative management, consideration of hip
preservation surgery in the form of a hip
arthroscopy should be considered.
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