Acetabular labral tears
"Think of the labrum as a little cushion that sits at the edge of the hip socket. It can tear for many different reasons. For some children the hip socket is shallow, so the labrum bears too much of the mechanical load, and that can make a tear. Occasionally, you can tear it in an injury, although it's usually more of a wear-and-tear issue than the result of trauma."
Young-Jo Kim, MD, PhD, orthopedic surgeon, Boston Children's Hospital
If your child or teen has an acetabular labral tear, you’ll have many concerns and questions about her health, treatment, recovery, outlook and other issues. It may comfort you to know that Children’s Hospital Boston is a world leader in pediatric orthopedics and we have a wealth of experience helping children with this condition. We specialize in innovative, family-centered care that supports your child and family every step of the way.
About acetabular labral tears
The labrum is a gristle-like, fibrous lining around the rim of the hip socket (acetabulum) whose cushioning characteristics:
- provide hip joint stability
- can offer extra structural support
- reduce friction in the joint
- distribute force evenly across the articular surface (cartilage)
A tear of the labrum usually causes sharp pain in the front of the hip, sometimes shooting down the thigh.
- A catching or giving way sensation in the hip may also occur.
- In some cases, patients may not feel any pain.
- Over time, an untreated acetabular labral tear can increase stress on the hip joint, causing deterioration and permanent damage to the joint. Acetabular labral tears may lead to osteoarthritis when your child is older, or be linked to arthritis in a way that’s still being studied.
Girls (especially dancers) and boys can both sustain acetabular labral tears.
- Children whose sports or dancing involves frequent rotation of the hip, such as golf, soccer, hockey and ballet, can have an increased risk for acetabular labral tears.
- About 22% of athletes who report groin pain have an acetabular labral tear.
Also at risk for acetabular labral tears are children with pre-existing hip problems, such as:
- Legg-Calvé-Perthes disease
- slipped capital femoral epiphysis
- developmental dysplasia of the hip
- Children with hip impingement (femoral acetabular impingement) usually have acetabular labral tears.
- Acetabular labral tears were once very difficult to identify and often went undiagnosed. Today’s advanced MRI imaging technology makes diagnosing these tears far more accurate.
- Advanced, minimally-invasive arthroscopic techniques are often very successful for the treatment of acetabular labral tears.
How Boston Children's Hospital approaches acetabular labral tearsand other developmental hip conditions
At Children's, acetabular labral tears may be treated non-surgically with pain medication and physical therapy. Severe cases may require arthroscopic surgery, but doctors at Children's will always identify the cause of the acetabular labral tear first, including an underlying hip condition.
Whatever treatment your child requires, you can have peace of mind knowing that, as national and international orthopedics referral centers, Children’s Child and Adult Hip Preservation Program, and Orthopedic Center have vast experience treating children who have treated every kind of hip condition, some of which few other pediatric hospitals have ever encountered. As a result, we can provide expert diagnosis, treatment and care for every level of complexity and severity of acetabular labral tear—and any possible underlying hip condition that may have caused it.
Unique expertise in treating adolescents with hip problems. Many adolescents and young adults with hip problems need diagnostic and surgical techniques that differ significantly from what’s indicated for younger children. Children’s Child and Adult Hip Preservation Program is the only such program of its kind. We offer our extensive experience and advanced techniques, with clinicians and researchers who are dedicated to finding better ways to care for adolescents and young adults with hip problems.
One of the first programs.Our Orthopedic Center is one of the world’s first comprehensive pediatric orthopedic programs, and today is the largest pediatric orthopedic surgery center in the United States, performing more than 5,000 procedures each year. Our program, consistently ranked among the top pediatric hospitals in the nation under preeminent care center for children and young adults with developmental, congenital, post-traumatic and neuromuscular problems of the musculoskeletal system.
Leaders in Bernese periacetabular osteotomy (Bernese PAO). At Children’s, we’ve performed more than 1,400 Bernese periacetabular osteotomies since 1991 to correct hip dysplasia (a major cause of acetabular labral tears) in teens and adults. Our large volume makes us the most experienced center in the United States for this procedure—and the second-most experienced in the world. The Bernese PAO—the most powerful procedure for repositioning the hip socket—is Children’s standard treatment for a hip socket that’s too shallow in a patient whose socket has finished growing (typically from age 13 or 14 through adult).
Acetabular labral tears: Reviewed by Young-Jo Kim, MD, PhD
© Children’s Hospital Boston, 2011
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