Dr. Michael Kushner

Hip

Lesión del tear

The labrum is a ring of fibrocartilage around the rim of the acetabulum. It acts as a seal that provides stability and distributes pressure inside the joint. When it tears or detaches — through impingement, dysplasia, trauma or wear — pain appears and sometimes a sensation of clicking, locking or catching in the groin.

The pain is usually deep in the groin and worsens with flexion, rotation, prolonged sitting or sudden pivoting. Diagnosis rests on the physical examination and on MRI (ideally with intra-articular contrast), which shows the lesion.

Many tears respond to conservative treatment (physiotherapy, activity modification and injections in selected cases). When pain persists, arthroscopy allows the labrum to be repaired or reattached and, crucially, correcting the underlying cause — the impingement or bony abnormality that damaged it — because repairing the labrum without correcting the cause leads to failure again.

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Dr. Kushner’s approach: repair the labrum, yes, but never in isolation. The key is to treat what tore it as well; otherwise the problem comes back.

When to seek care without waiting

Frequently asked questions

Does it heal on its own?

An established tear does not heal by itself, but many patients improve their symptoms with conservative treatment. Surgery is for those who do not improve.

Can it tear again after surgery?

The risk drops considerably when, in addition to repairing the labrum, the cause that damaged it is corrected.

Can it settle without surgery?

A torn labrum does not heal on its own, but many patients become symptom-free with targeted physiotherapy and load management. Surgery is for symptoms that persist despite properly delivered conservative treatment.

Why does the shape of the bone matter too?

Because most labral tears are not isolated accidents: they come from impingement striking the labrum repeatedly. Repairing the labrum without correcting the cause makes the problem return.

Does MRI always show it?

Not always. MR arthrography improves detection, but the diagnosis is made from the whole picture: history, examination and imaging. Labral findings also appear in people with no pain at all.

References

  1. Hurley ET, et al. Repair versus debridement for acetabular labral tears — a systematic review. Arthrosc Sports Med Rehabil. 2021;3(5):e1569-e1576. DOI
  2. Griffin DR, et al. Hip arthroscopy versus best conservative care for femoroacetabular impingement syndrome (UK FASHIoN). Lancet. 2018;391(10136):2225-2235. DOI
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Reviewed by Dr. Michael David Kushner Shrem, orthopaedic and hip, pelvis and trauma surgeon in Panama. AO Foundation Faculty and Education Chair of AO Panama, fellowship-trained at Hadassah Ein Karem Hospital (Hebrew University of Jerusalem).

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Book a consultation with Dr. Kushner at COMEDSA. Bring any previous imaging for a complete assessment.

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Educational information reviewed by Dr. Michael Kushner Shrem. It does not replace an in-person medical assessment.