Labrum Tears and Arthroscopy

Labrum Tears and Arthroscopy

Learn how arthroscopy can effectively treat labral tears in the hip and shoulder. Discover symptoms, diagnosis methods, surgical procedures, and recovery expectations.

The labrum is a fibrocartilaginous structure located in major joints such as the hip and shoulder. It forms a ring around the socket, providing joint stability, maintaining intra-articular pressure, and enhancing shock absorption. When the labrum is torn—whether from trauma, repetitive stress, or structural abnormalities—arthroscopic surgery has become the preferred minimally invasive technique for both diagnosis and treatment.

What Is the Labrum and What Does It Do?

In the hip joint, the labrum surrounds the acetabulum (hip socket), while in the shoulder, it lines the glenoid rim. The main functions of the labrum include:

• Stabilizing the joint by securing the ball (femoral or humeral head) within the socket
• Preserving joint fluid and pressure
• Acting as a cushion to absorb impact
• Increasing surface contact to ensure smoother joint motion

These functions are essential for joint integrity and movement efficiency.

Causes of Labral Tears

Tears can occur for several reasons:

• Trauma: Falls, collisions, or sudden directional changes
• Repetitive Stress: Common in athletes (e.g., football, tennis, gymnastics)
• Structural Issues: Femoroacetabular impingement (FAI), acetabular dysplasia
• Degeneration: Age-related cartilage wear and tear

Symptoms of a Labral Tear

Labral tears often develop gradually and may present with the following symptoms:

• Deep anterior hip or shoulder pain
• Increased pain with activities like sitting, squatting, or overhead movements
• Clicking, locking, or catching sensations
• Reduced range of motion
• Decline in athletic performance

How Is It Diagnosed?

Diagnosis begins with a detailed physical examination and is confirmed with imaging:

• Magnetic Resonance Imaging (MRI): Especially MR arthrography with contrast is highly effective in visualizing labral tears
• X-rays: Useful for detecting accompanying bony abnormalities like FAI
• CT Scan: Helpful for pre-surgical assessment of bone structure

Role of Arthroscopy in Labral Tears

Arthroscopy is a minimally invasive surgical technique that uses small incisions, a camera, and specialized instruments to view and treat joint conditions. In labral tears, both hip and shoulder arthroscopy serve as the gold standard for diagnosis and repair.

Benefits of Arthroscopy:

• Smaller incisions and reduced tissue trauma
• Less postoperative pain and faster recovery
• Shorter hospital stays
• Quicker return to daily life and sports

Surgical Procedure

Performed under general anesthesia, the steps include:

1. Diagnostic arthroscopy to evaluate the tear’s type and extent
2. Debridement of frayed tissue or repair with sutures
3. Concurrent treatment of coexisting issues like FAI or cartilage damage

Treatment Options

Treatment is customized based on tear severity, patient activity level, and presence of other joint problems:

• Conservative Management: For mild cases—rest, physical therapy, anti-inflammatories, and injections like PRP
• Arthroscopic Debridement: Removal of loose or frayed labral tissue
• Arthroscopic Repair: Suturing the torn labrum for structural integrity
• Labral Reconstruction: For large or recurrent tears, grafts may be used to rebuild the labrum

Rehabilitation After Surgery

Recovery varies, but general principles include:

• Use of crutches for 1–2 weeks (in hip procedures)
• Gradual physical therapy to restore motion and strength
• Focused rehab to regain joint stability and neuromuscular control
• Return to sports typically after 3–4 months

Who Is a Good Candidate for Arthroscopic Repair?

• Active individuals aged 18–55
• Athletes experiencing performance loss due to joint pain
• Patients with confirmed labral tears on MRI and persistent symptoms
• Those who haven’t responded to conservative therapy