Acetabular labral tears

Children’s Hospital Boston’s hip sub-specialists provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care to children, teens and young adults. How we’ll treat your child’s acetabular labral tear is determined by your child’s doctor based on:

• his age, overall health and medical history
• the type, extent and severity of the tear

Conservative treatment
Treatment may include conservative approaches such as:

• rest
• activity restrictions
• anti-inflammatory and pain medications
• exercises and physical therapy (to strengthen the muscles around the hip joint and avoid stress)

Arthroscopic surgery

The labrum can be a difficult area to heal on its own, because there’s blood supply to only a part of the area. So if the labrum doesn’t heal with conservative treatments, doctors may perform minimally invasive arthroscopic surgery: Through a small incision, a thin, flexible fiberoptic scope “sees” the joint, and the surgeon uses instruments for repair.

The arthroscopic procedure that your child’s surgeon uses to trim/remove (debride) or repair the damaged tissue depends on:

• the type of tear
  • type 1: the labrum detaches at in the area where it transitions to the articular cartilage; surgery is to reattach to the acetabular rim, usually with an anchor
  • type 2: an intra-substance split with one or more cleavage planes
• the cause of the condition
• the degree of damage

After surgery

After surgery, your child will need to limit her weight-bearing with crutches, probably for four to six weeks. Physical therapy will help her restore her muscle strength and range of motion. She’ll probably be able to resume full activities, including sports, two to six months after surgery.

Long-term outlook

Hip arthroscopy is very successful in relieving symptoms and improving hip function as long as there aren’t any underlying anatomic problems around the hip, or as long as any problems that did exist have been corrected.

If there is an underlying hip condition associated with your child’s acetabular labral tear, the long-term result of surgery depends on the amount of damage present at the time of surgery. For example, in a condition such as hip impingement (with its attendant acetabular labral tear), a perfect outcome is possible with early joint-preserving treatments before the cartilage is damaged. But even surgery may not be able to fully repair the impingement if the cartilage has already been severely damaged.

Coping and support

We at Children’s understand that a hospital visit can be difficult. So, we offer many amenities to make your child’s—and your own—hospital experience as pleasant as possible. Visit theCenter for Families for all you need to know about:

• getting to Children’s
• accommodations
• navigating the hospital experience
• resources that are available for your family

In particular, we understand that you may have a lot of questions when your child is diagnosed with an acetabular labral tear. Will my child need surgery? How long will her recovery take? Will it affect her long term? What should we do at home? Children’s can help you connect with extensive resources to help you and your family through this stressful time, including:

• patient education: From doctor’s appointments to treatment to follow-up, our nurses and physical therapists will be on hand to walk you through your child’s diagnosis, surgery and recovery. And once your child is home, we’ll help you coordinate and continue the care and support she received at Children’s.
• parent-to-parent: Want to talk with someone whose child has been treated for an acetabular labral tear? Our Orthopedic Center can often put you in touch with other families who’ve been through the same experience that you and your child are facing.
• faith-based support: If you’re in need of spiritual support, we’ll connect you with the Children’s chaplaincy. Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital experience.
• social work: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child’s diagnosis, stresses relating to coping with illness and dealing with financial issues.
  

  A long line of orthopedic firsts
  Designed by Children’s psychiatrist-in-chief David DeMaso, MD, and members of his team, the Experience Journal is an online collection of thoughts, reflections and advice from kids, parents and other caregivers about a variety of medical experiences, including hip problems.