Treatment of Hip Labral Tears

Initial Management and Diagnosis

The American College of Radiology recommends starting with plain radiographs to evaluate for dysplasia, femoroacetabular impingement (FAI), joint space narrowing, and other bony pathology 4
MR arthrography is the gold standard for confirming labral tears, rated 9/9 (usually appropriate) by the American College of Radiology 2, 3
Direct MR arthrography with intra-articular gadolinium injection provides superior visualization compared to standard MRI (rated only 6/9) 1, 3
CT arthrography is an alternative (rated 7/9) if MRI is contraindicated 3
High-resolution 3T MRI may improve visualization and potentially eliminate need for arthrography in select cases 1, 3

Arthroscopic labral repair with suture anchors is the preferred technique over simple debridement, as it preserves the labral seal and load distribution function of the hip joint 1, 2
For small delaminated cartilage lesions (<3 cm²): Perform debridement followed by microfracture of exposed subchondral bone, or repair healthy-appearing delaminated cartilage with sutures or fibrin adhesive 1, 2, 3
Femoroacetabular impingement is a common causative factor requiring concurrent correction 5, 6

Patients with extensive cartilage damage have less favorable outcomes and may require additional interventions 1, 2
Untreated labral tears lead to persistent pain, progressive cartilage damage, and osteoarthritis development 1, 2, 3

Avoid stem cell injections for cartilage regeneration due to lack of standardization 2