CARTILAGE & LABRAL TEARS

There are two types of cartilage in the hip. The first is the articular cartilage, this is the smooth hard-wearing cartilage that is affected in hip osteoarthritis as we have talked about above. The second is the labrum. This is a different type of cartilage, it is triangular in cross section and attaches to the rim of the acetabulum or cup. It effectively deepens the socket and helps with joint lubrication and stability. 

 

The problem with the location of the labrum is that if the hip is flexed and turned in (internally rotated), then the labrum can be squeezed between the neck of the femur (thigh bone) and the edge of the acetabulum (cup). If this happens suddenly during sports or an accident, it may lead to a large tear or to the labrum being detached from the rim of the cup. This can lead to you feeling a clunking sensation in the hip, instability or more commonly, pain. If the labrum has torn away from the cup, it may need to be reattached. In order to determine if this is the case, you will need to have a special type of scan performed where dye is injected into the hip and an MRI scan is performed.

 

The other kind of labral teat that can occur, happens when the same kind of problem as above occurs but the labrum is squeezed between the neck of femur and the cup repeatedly. This is termed a degenerative tear. These are more common as you get older and the labrum gets stiffer. The labrum attaches to the articular cartilage in the cup and if it is damaged, can cause the cartilage in the cup to peel away from the bone. It is therefore very important with this kind of problem, to determine if the pain is actually coming from the damage to the labrum or is due to early arthritis. We can find out which is the case by carefully examining your hip and performing the right kind of imaging to determine what is causing your symptoms. If this is not done, there is a high risk that you could undergo treatment but your symptoms not be improved as much as you would have hoped for or that you may need further treatment in the near future.