Mr Araz B. Massraf

Consultant Orthopaedic Surgeon
MBCHB, FRCSI, FRCS (Orth & Trauma)

Hip Labral Tear

The treatment of labral tears and their associated disorders is crucial for hip preservation in young and active patients because several studies have demonstrated an association between labral tears and the early onset of osteoarthritis. Groin pain has always posed a clinical and diagnostic challenge. Advance in understanding of hip pathology lead to new hypothesis labral tears: — 5% of sport injuries are groin related.
— Accurate diagnosis is often difficult.
— 30% of hip OA are attributed to primary OA, the rest are secondary.
— Secondary to trauma, femoroacetabular impingement, instability, psoas impingement, dysplasia, and degenerative arthritis.


Overview of the Anatomy and Function of the Labrum

The acetabular labrum is a fibrocartilaginous structure thatis located circumferentially around the acetabular perimeter of the hip joint and becomes attached to the transverse acetabular ligament posteriorlyand anteriorly.

Neuroreceptors have been identified within thelabrum, and these structures may provide proprioception to the hip joint. The articular surface of the labrum has decreased vascularity and a limited synovial covering in comparison withthe portion of the labrum at the peripheral capsulolabral junction.Thus, similar to the healing potential of the menisci in the knee, which is greatest at the periphery, the healing potentialof the labrum is greatest at the peripheral capsulolabral junction.

Labrum has an important sealing function in the hip. Itplays a role in limiting the expression of fluid from the jointspace and also helps contain the femoral head at extreme ranges of motion, particularly hip flexion. In the absence of the labrum, increased contact pressures are transmitted across the hip joint.



Peri articular causes

— Trochanteric bursitis.
— Snapping hip.
— Adductor tendinopathy.
— Sportsman's groin.
— lPiriformis syndrome.
— Obturator nerve entrapment.
— lOsteitis pubis.

Trochanteric Bursitis
(Peri articular causes)
Causes

— Overuse of the trochanteric bursa.
— A direct fall on the side of the hip
— Repetitive movements.
— Prolonged or excessive pressure to the area.
— Underlying surgical wire, Implants or scar tissue in the hip area
— Differences in leg length

Snapping hip
(Peri articular causes)

— External.
Iliotibial Band.
Greater Trochanter.
— Internal.
Iliopsoas Tendon.
Iliopectineal Eminence.
— Intra-articular.


Short Bio

Mr Araz MASSRAF qualified in 1988 He had High Specialist Orthopaedic Training in Glasgow. He is full time Orthopaedic Consultant in Peterborough, UK. seeing NHS and private patients.

His main interests are: Hip & Knee surgeries, Hip impingement decompression and labral repair, Birmingham hip resurfacing, Hip & Knee Keyhole surgeries, Hip & Knee revision arthroplasty.


Causes of groin pain

— Peri articular causes (out side the joint).
— Articular causes (in side the joint).
— Referred pain (not related to the joint).


Articular causes

— Femoro-acetabular impingement.
— Labrum and cartilage tear.
— Early osteoarthritis of the hip joint.
— Ligamentum teres tear.
— Dysplasia and instability of the hip joint.



Get in Touch

Secretary:
Mrs A.C. McDermott
Tel 079809989421
Fax 01778 423476

Consulting Rooms:
Fitzwilliam Hospital
Milton Way
South Bretton
Peterborough
PE3 9AQ
Booking: 01733 261717

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