Hip Labral Tear
What You Need to Know
- 唇裂是一种将髋关节的球窝部分连接在一起的组织损伤.
- Torn hip labrum may cause pain, 髋关节活动范围缩小，髋关节有锁住感.
- Labral tears are typically caused by overuse, 髋骨畸形髋骨形状或排列上的创伤或异常.
- Hip labral tears can be treated with or without surgery. 如果需要手术，可以采用微创方法.
What is a labral tear of the hip?
髋关节唇撕裂是髋关节唇部的一种损伤，唇部是髋关节窝部的一圈软骨. Your hip joint is a ball-and-socket joint, composed of the ball, which is the top of your femur (femoral head) and a socket, which is part of your pelvis (acetabulum). 当你移动时，唇状肌帮助保持髋关节的骨头对齐和就位. 它还有助于保持关节内的关节流体，以确保无摩擦运动.
The extent of hip labral tears can vary. Sometimes, hip labrum can have mini tears or fray at the edges. This usually happens due to a gradual wear on the labrum. 在其他情况下，髋关节唇的一部分会从窝骨上分离或撕裂. These types of hip labrum injuries are usually due to trauma.
Types of Hip Labral Tears
A hip labral tear can occur anywhere along the labrum. 医生有时将唇裂分为前部或后部, depending on which part of the joint is affected:
- Anterior hip labral tears: The most common type of hip labral tear. These tears occur on the front of the hip joint.
- Posterior hip labral tears: These tears occur on the back of the hip joint.
Hip Labral Tear Symptoms
无论是何种类型的撕裂，髋唇撕裂都会引起相似的症状. 但你感觉到的症状可能会有所不同，这取决于撕裂是在髋关节唇的前部还是后部.
Hip labral tear symptoms include:
- Pain in the hip, groin or buttocks, especially as you walk or run, and sometimes at night when you sleep.
- Hip stiffness or limited range of motion
- A clicking or locking sensation in the hip joint when you move
一些髋关节的唇裂可能没有任何症状，并且可能多年不被注意到.
Hip Labral Tear Causes
Hip labral tears can happen to anyone. 髋唇可以突然撕裂，也可以由于撞击而逐渐撕裂. Causes typically include:
- 重复髋关节运动和髋关节过度使用(特别是在某些运动和职业中)
- Traumatic hip injuries
- Regular wear and tear of the hip
- Deformities of the hip joint, such as hip dysplasia and abnormal bone shape that leads to hip impingement, can increase stress on the labrum.
- Degenerative conditions such as osteoarthritis. 骨关节炎和髋关节唇裂之间的关系是双向的:关节炎引起的软骨侵蚀会导致唇裂, 唇裂会让你更容易在几年后患上关节炎.
髋唇撕裂的原因可能因撕裂的位置而异. 髋前唇撕裂通常是由诸如芭蕾等运动中常见的重复动作引起的, golf, football or hockey. 髋后唇撕裂通常是由创伤性损伤引起的，如跌倒, accidents or high-impact sports injuries.
How are hip labral tears diagnosed?
您的医生可能会使用以下诊断方法来确定您的症状是否由髋关节唇部撕裂引起:
- Physical exam to assess signs of swelling and inflammation, your range of motion in the hip and movements that cause pain.
- X-ray 检测髋关节形状或排列的异常以及关节炎的迹象.
- MRI scan 使用或不使用造影剂来更好地观察髋关节周围的软组织, including hip labrum.
If the labral tear diagnosis is still unclear after these tests, 你的医生可能会建议你在超声波引导下注射止痛药. 如果它能减轻疼痛，那么很可能是唇裂的原因.
Can a hip labral tear heal on its own?
Hip labral tears do not heal on their own. However, 如果你的撕裂是轻微的，没有造成太大的疼痛或限制你的活动, 不修复撕裂也能控制症状.
Hip Labral Tear Treatment
There are several options to treat labral tears of the hip. Typically, your doctor will recommend nonsurgical treatments first, but depending on the severity of the tear and your pain, surgery may be the best approach.
Nonsurgical Treatments
髋关节唇部撕裂的非手术治疗侧重于控制症状和防止进一步损害唇部:
- Rest and activity modification 旨在减少或消除引起疼痛和加重损伤的运动.
- Over-the-counter medications such as ibuprofen can help manage pain and inflammation.
- Injections 如果非处方药物不能有效缓解疼痛和炎症，在髋关节注射类固醇和麻醉剂可以暂时缓解疼痛和炎症.
- Physical therapy 包括一些可以帮助加强和伸展臀部肌肉的运动，这样它们就能更好地支撑关节，让你在运动时减少疼痛.
Johns Hopkins Hip Preservation Clinic
Hip Labral Tear Surgery
If your hip labral tear is severe, or if you are still in pain after trying nonsurgical options, your doctor may recommend surgery. The most common surgery to repair hip labral tears is arthroscopic surgery. 在这个过程中，整形外科医生会做几个小切口来进入髋关节. With the help of a special camera device called an arthroscope, 外科医生定位唇裂并使用手术工具进行修复.
修复髋关节唇裂可能需要移除磨损的唇瓣, 将撕裂处缝合或使用身体其他部位的组织来替换缺失的唇状组织.
If your labral tear was caused by a hip impingement, 外科医生会通过重塑你的髋关节骨骼来解决这个问题，这样它们就能平稳地滑动.
Recovery After Hip Labrum Repair
关节镜手术通常是门诊手术，这意味着你可以当天回家. After your hip labrum repair, 您将能够立即回到步行等低冲击活动中. 你的外科医生会把你推荐给物理治疗师，开始锻炼你的髋关节，以恢复你的活动范围，加强关节.
If your job is in a low-activity environment, such as an office job, 你可以在髋关节唇裂手术后的一到两周内重返工作岗位. If your job puts significant stress on the hip, 你可以和你的理疗师一起确定一个安全的返回日期，或者和你的雇主讨论工作调整，让你在康复的过程中轻松地回到工作中.
