Hip

Hip Labrum Tears: How To Treat Without Surgery?

By Last updated on September 3rd, 2020 Last updated on September 3rd, 2020 No Comments

Some injuries seem to only end with the option of surgery, especially injuries where the tissue is not capable of healing on its own. A labrum tear in the hip is one such injury.

Because of this, treatment focuses on managing the symptoms and improving the quality of life for pain sufferers. The emerging field of regenerative medicine, however, seeks to treat the root cause of pain in the labrum.

Read on to learn more about what is occurring inside the hip, and what you can do about it.

What is Labrum?

The hip joint is a ball-and-socket joint. This means that the femoral head, the top of the thigh bone, fits into the acetabulum, a concave portion of the pelvic bone. This structure allows legs to have a very wide range of motion.

Femoral head and the acetabulum is a piece of cartilage called the labrum. The labrum serves as a cushion between the acetabulum and the femoral head, as well as allowing the joint to glide smoothly during activities.

There are many other small structures in the hip joint that support it such as muscles and tendons. Any of these structures are prone to injury due to the frequency that the hips are used. A common injury in the hip joint is a tear of the muscles, cartilage, or other soft tissues.

Soft tissue in a joint can tear as a result of a high impact injury such as a car accident, or the soft tissue can become worn down overtime with use. This process is natural and happens to everyone, but some people may be more likely to experience it due to frequent activity or degenerative disease.

What Happens if the Labrum Tears?

A torn labrum is likely the result of a degenerative disease such as arthritis. Such a disease occurs when soft tissue, like cartilage, deteriorates over time. This causes bones to rub against one another which leads to further damage and pain and discomfort in an individual.

A torn labrum can be difficult to diagnose because patients may not always show signs of injury. Though it’s more common for a labrum tear to cause certain symptoms, it’s important that someone who is suspicious of an injury gets tested by a doctor.

Some of the telltale signs of a labrum tear include:

  • Deep, aching pain in the groin or buttocks
  • The sensation of the joint locking or clicking
  • Instability
  • Difficulty with certain tasks, like sitting or standing
  • Inability to rest on the affected side

It is important to discuss all symptoms with a medical professional, as there are some signs that may not seem relevant but may be indicative of certain conditions. When talking to a doctor, be sure to include any and all information about an injury, including how it happened, how long it’s been causing problems, and what activities are difficult because of hip pain.

With this information under their belt, doctors will begin to diagnose the condition by using certain imaging techniques and physical exercises that they observe. The physical exercises may consist of watching the patient walk,  which allows doctors to check for a limp, as well as bending the hip to see where pain strikes. The imaging techniques they may use include MRI, x-ray, and CT scans, which provide doctors with an image of the joint. Looking at an image of the joint allows doctors to determine the source of pain – it can indicate if degeneration is occurring, how the bone structure is holding up, and other potential abnormalities of the joint.

Doctors may also inject anesthesia into the joint, which can be used as a diagnostic tool. If pain is relieved from an anesthesia injection it is indicative that the injury is occurring inside the joint, rather than somewhere outside of it.

In many cases, a labral tear occurs as a result of another injury or disease. This means that it is important for doctors to check for all of the possible causes of hip pain. Structures of any joint are very interconnected and dependent on each other for support – meaning that if one becomes injured, it can cause structural damage which then becomes more injuries.

Conventional Treatment

Unlike some other injuries to the soft tissue, a labrum tear does not heal on its own. This means that treatment consists mostly of managing symptoms. If symptoms do not go away after trying these treatments, many doctors turn to surgery to correct the damaged tissue by either by removing it or other means of reparation. Some common treatments many people try before surgery are:

  • Pain Management: over-the-counter anti-inflammatory drugs such as Ibuprofen and Naproxen can help manage pain, allowing the patient to better tolerate activities that may have been difficult before. For unmanageable or severe pain, doctors may recommend stronger painkillers via a prescription. These can be dangerous, so it is important to discuss the risks and side effects with a medical professional before beginning use.
  • Corticosteroid Injections: a powerful anti-inflammatory injection can reduce pain significantly. For patients who are experiencing degeneration of soft tissue due to a condition like arthritis, these injections are not recommended because they can cause further damage to soft tissue over time – this is not a long-term solution to pain.
  • Physical Therapy: many patients have great success with physical therapy. It is one of the most effective ways to increase a patient’s independence, and regain a sense of control over the injury. Physiotherapists focus on strengthening the joint and relieving pain.

If symptoms persist through these treatments, the next option in the process is arthroscopic surgery. Using a tiny camera for guidance and tiny tools for reparations, surgeons are able to remove damaged tissue. Some labrum tears result in dead or diseased tissue inside or around the joint, which can cause pain and discomfort. Removing this tissue can relieve symptoms, but again, does not address the root cause of the injury.

In extreme cases, surgeons may consider a partial or total hip replacement surgery – this is a major surgery that consists of a long and difficult recovery. So, it is no surprise that many patients are considering alternative treatments to their hip pain – it may be possible to avoid surgery altogether.

Alternative Treatments That Address the Cause of Pain

The field of regenerative medicine works on the body as the name suggests – by targeting its naturally occurring regenerative cells. Two of these regenerative superstars are platelets and stem cells.

Platelet-Rich Plasma (PRP) Therapy begins with a blood draw. The patient’s blood is then placed in a centrifuge, which separates platelets from other components in the blood that aren’t necessary for the procedure. Once the platelets are more concentrated, they are injected into the hip, using imaging technology such as Ultrasound or MRI to guide the needle to the location where it will provide the best results.

Platelets are a component of the blood that contain growth factors and proteins that are an invaluable component of the body’s natural healing process. Increasing the amount of such cells in an injury site, like a torn labrum, can help the cartilage to regrow and heal itself. This treatment has been proven as an effective way to treat many soft tissue injuries. These cells also promise pain relief, as they are able to reduce inflammation around the injured joint.

Stem Cell Therapy begins with an extract of stem cells, which may come from a blood sample, fat tissue, or bone marrow. The cells are then processed and injected into the hip joint in a similar fashion as PRP.

Stem cells are used in the body’s natural healing process in a way that is similar to PRP – they can call to other healing cells and send them to the injury to begin their work. Stem cells are valuable in the body because they have the ability to “differentiate”, or turn into other cells. This allows them to heal something like a labrum tear by regenerating necessary tissue.

Treatments like these are important to consider when faced with all of the options, as they are some of the only treatments on the market that seek to address and correct the actual cause of injury, rather than just managing symptoms.

Regenerative medicine can be a good option to prevent the need for surgery, but it can also be used after an operation to help repair tissue that gets damaged in the process.

Conclusion

A labrum tear is not the end of the world – many individuals faced with this injury are able to recover in a matter of weeks. Persistent pain even after treatment may result in surgery, but it doesn’t have to. There are options available now that seek to heal the injury rather than just manage symptoms of it.

Dr. Matthew HC Otten

Dr. Matthew HC Otten

Director of Regenerative Orthopedic and Sports Medicine
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan State University Alumni