Hip labral tear
A tear of the fibrocartilaginous labrum surrounding the acetabulum (hip socket), causing groin pain and clicking in young adults. Most commonly associated with femoroacetabular impingement.
📊 Labral tears are found on MRI arthrogram in up to 55% of patients with hip pain. They are the most common intra-articular pathology in young adults with hip pain and are closely associated with FAI morphology.
What is a hip labral tear?
The acetabular labrum is a ring of fibrocartilage attached to the rim of the acetabulum that deepens the hip socket, improves joint stability, and acts as a seal to maintain fluid pressure within the joint. Labral tears disrupt the normal sealing function, causing pain, clicking, and reduced hip joint lubrication. The anterosuperior labrum (the top-front portion) is the most commonly torn region, corresponding to the area of maximum cam or pincer impingement.
Labral tears are classified by their morphology (radial, longitudinal, bucket-handle), location, and depth. The majority are associated with underlying FAI morphology. Isolated labral tears without FAI morphology are less common and may be associated with hip dysplasia or hypermobility. In the presence of FAI, treating the bony impingement at the time of labral repair is essential to prevent re-tear.
Hip arthroscopy for labral repair combined with FAI correction (cam resection and rim trimming) achieves significantly better outcomes than physiotherapy alone in patients with symptomatic FAI and labral tears (FAIT trial, Lancet 2018). Labral reconstruction using iliotibial band or ligamentum teres autograft is performed when the labrum is too damaged to repair.
Common causes
- Femoroacetabular impingement (cam or pincer morphology) - the most common cause
- Hip dysplasia (undercoverage of the femoral head)
- Repetitive pivoting and twisting activities
- Traumatic injury to the hip
- Generalised hypermobility
Who is at risk? Young athletes in pivoting sports (football, hockey, dance, gymnastics), those with FAI morphology, and patients with hip dysplasia are at highest risk.
Symptoms
Symptoms vary depending on the severity and duration of the condition. Common symptoms include:
- Deep anterior groin pain in young adults
- A C-sign (patient cups their hand around the outer hip to indicate the pain region)
- Clicking or catching sensation in the hip
- Pain with hip flexion activities (sitting, cycling, squatting)
- A positive FADIR test (flexion, adduction, internal rotation reproduces groin pain)
- Pain that limits sport or prolonged sitting
When to seek help: See your GP if you have persistent groin pain not responding to rest and simple analgesia. MRI arthrogram should be arranged to assess for a labral tear and underlying FAI morphology.
How is it diagnosed?
Your surgeon will take a detailed history and examine the joint. The following investigations may be arranged to confirm the diagnosis:
- MRI arthrogram - gold standard for labral tear diagnosis (gadolinium injection into the joint improves sensitivity)
- X-ray - assesses bony morphology (cam and pincer deformity, dysplasia)
- CT scan - precise measurement of cam morphology and acetabular version for surgical planning
- Clinical examination - FADIR test, FABER test, range of movement assessment
Standard MRI without arthrogram has lower sensitivity for labral tears than MRI arthrogram. In young patients with hip pain and a suspected labral tear, MRI arthrogram is the preferred investigation.
Treatment pathway
Treatment is tailored to the severity of the condition, your age, activity level, and overall health. Most conditions are treated in a stepwise fashion, starting with the least invasive options.
Physiotherapy and activity modification
Hip abductor and rotator strengthening, core stability, and activity modification to avoid provocative positions. A structured 3-month physiotherapy programme should be completed before surgical referral.
Hip arthroscopy with labral repair and FAI correction
Arthroscopic labral repair (suture anchors) combined with cam resection (osteoplasty) and rim trimming as appropriate. Addressing the underlying bony morphology is essential to prevent re-tear. Labral reconstruction with autograft is performed for irreparable labra.
Recovery
Recovery after hip arthroscopy requires a structured programme with protected weight-bearing for 2-4 weeks. Return to sport takes 4-6 months and is guided by functional criteria.
- Physiotherapy: 3-6 months (first line)
- After arthroscopy: crutches: 2-4 weeks
- Return to low-impact activity: 6-8 weeks
- Return to sport: 4-6 months
- Full recovery: 6-9 months
What results can I expect?
Hip arthroscopy for labral tear combined with FAI correction achieves significant pain relief and functional improvement in 80-85% of patients with minimal pre-existing arthritis. Outcomes are less predictable in patients with advanced cartilage damage.
Hip labral tear - arthroscopy and repair
In numbers
Typical activity timelines for this condition. These are approximate and vary considerably between patients. Always follow the specific guidance given by your surgeon and physiotherapist.
| Activity | Typical timeline | Notes |
|---|---|---|
| Try physiotherapy | At least 3 months | A structured physiotherapy programme is the appropriate first step in most cases.[2] |
| Modify activity | During treatment | Reduce deep hip flexion (deep squats, prolonged sitting in low chairs) while symptoms settle.[1] |
| Consider a diagnostic injection | Before surgery | A local anaesthetic injection into the hip helps confirm that pain is coming from inside the joint.[1] |
| Drive after hip arthroscopy | 3-4 weeks | When off crutches and comfortable controlling the car. Inform your insurer.[3] |
| Return to work | 2-8 weeks after arthroscopy | Desk work usually 2 weeks. Manual work 6-8 weeks or longer.[1] |
| Straight-line running | 3-4 months after arthroscopy | Once strength and range of motion have returned and rehab milestones are met.[1] |
| Return to pivoting sport | 4-6 months after arthroscopy | Cutting and pivoting sport requires more rehab; guided by functional testing.[1] |
Common concerns from patients with this condition or recovering from treatment, and whether they are expected or worth mentioning to your team.
Your questions, answered
Plain-English answers to the things people most often ask, grounded in UK clinical guidance. Tap a question to open it.
About thisWhat is a hip labral tear?
The labrum is a rim of cartilage around the edge of the hip socket that helps seal and stabilise the joint. A tear can result from a twisting injury, repetitive movement in sport, or be linked to the shape of the hip in conditions such as impingement.
SymptomsWhat are the symptoms?
The usual symptom is groin pain, sometimes with clicking, catching or a sense that the hip is locking or giving way. Pain is often brought on by deep bending of the hip, prolonged sitting, or pivoting movements.
Link to FAIIs it connected to impingement?
Often, yes. Many labral tears occur alongside femoroacetabular impingement, where the abnormal bony contact damages the labrum over time. This is why assessment usually looks at the shape of the hip as well as the tear itself.
TreatmentHow is it treated?
Many people improve with physiotherapy, activity modification and pain relief, which is usually the first approach. Keyhole surgery to repair the labrum, and to address any underlying impingement, is considered when symptoms persist despite non-surgical care.
RecoveryWhat is recovery like?
If managed without surgery, symptoms often improve over weeks of rehabilitation. After keyhole repair you use crutches for a few weeks and follow a structured physiotherapy programme, with return to sport usually taking several months.
When to worryWhen should I get it checked sooner?
Seek review sooner if the hip locks, gives way, or becomes suddenly much more painful, if night pain is not settling, or if you cannot bear weight after an injury.
- 1.British Hip Society: Patient information
- 2.Chartered Society of Physiotherapy: Patient information
- 3.Royal College of Surgeons of England: Recovering from surgery, driving guidance
- 4.BMJ: Femoroacetabular impingement, evidence summary
References are to UK clinical guidance and patient information from recognised organisations. This page is for general information and does not replace personalised advice from your own clinical team.
Preparing for surgery?
Read our step-by-step guide - what to expect before, during, and after your procedure.
How is it diagnosed?
- ✓MRI arthrogram - gold standard for labral tear diagnosis (gadolinium injection into the joint improves sensitivity)
- ✓X-ray - assesses bony morphology (cam and pincer deformity, dysplasia)
- ✓CT scan - precise measurement of cam morphology and acetabular version for surgical planning
- ✓Clinical examination - FADIR test, FABER test, range of movement assessment
Recovery milestones
- ●Physiotherapy: 3-6 months (first line)
- ●After arthroscopy: crutches: 2-4 weeks
- ●Return to low-impact activity: 6-8 weeks
- ●Return to sport: 4-6 months
- ●Full recovery: 6-9 months