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| <div class="noeditbox">Welcome to [[Texas State University Evidence-based Practice Project|Texas State University's Evidence-based Practice project space]]. This is a wiki created by and for the students in the Doctor of Physical Therapy program at Texas State University - San Marcos. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox">
| | #REDIRECT [[Hip Labral Disorders]]<br> |
| '''Original Editor '''- [[User:Alisha Lopez|Alisha Lopez]]
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| '''Lead Editors''' - [[User:Chris Slininger|Chris Slininger]], [[User:Kristen Tsuei|Kristen Tsuei]], [[User:Jenny Nordin|Jenny Nordin]], [[User:Tom Lawlor|Thomas F Lawlor]], [[User:Alisha Lopez|Alisha Lopez]]
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| </div>
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| == Search Strategy ==
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| '''Databases Searched: PTJ, Pubmed, CINAHL'''
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| '''Keywords Searched: hip labral tears, acetabular labrum, acetabular labral tears, Hip labral lesions & examinations<br>'''
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| '''Search Timeline: July 1 2011 -'''
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| == Definition/Description ==
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| The hip labrum is a structure made of dense connective tissue and fibrocartilage that outlines the<br>acetabular socket. This continuous structure composed of Type 1 collagen attaches to the bony rim of the acetabulum. The labrum is wider and thinner in the anterior region of the acetabulum and thicker in the posterior region. <ref name="comp">Groh MM, Herrera J. A comprehensive review of hip labral tears. Curr Rev Musculoskeletal Med. 2009; 2:105 - 117.</ref><ref name="LS">Lewis C, Sahrmann S. Acetabular labral tears. Physical Therapy. 2006;86(1):110-121.</ref>
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| As for the blood supply, it is thought that the majority of the labrum is avascular with only the<br>outer third being supplied by the obturator, superior gluteal, and inferior gluteal arteries. There is<br>controversy as to whether there is a potential for healing with the limited blood supply. The superior and inferior portions are believed to be innervated and contain free nerve endings and nerve sensory end organs (giving the senses of pain, pressure, and deep sensation). <ref name="comp" /><ref name="LS" />
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| The labrum functions as a shock absorber, joint lubricator, and pressure distributor. It resists<br>lateral and vertical motion within the acetabulum along with aiding in stability by deepening the joint by 21%. The labrum also increases the surface area of the joint by 28%. This allows for a wider area of force distribution and is accomplished by creating a sealing mechanism to keep the synovial fluid within the articular cartilage. <ref name="comp" />
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| Labral tears can be classified by their location (anterior, posterior, or superior/lateral),<br>morphology (radial flap, radial fibrillated, longitudinal peripheral, and unstable), or etiology.<ref name="comp" /> It is generally accepted that most labral tears occur in the anterior, anterior-superior, and superior regions of this acetabulum.<br> | |
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| == Epidemiology/Etiology ==
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| With the advent of arthroscopic surgery as an accurate means of diagnosis (MRA), hip labral injuries have become of growing interest to the medical profession. Direct trauma, including motor vehicle accidents and slipping or falling with or without hip dislocation, are known causes of acetabular labral tears. (Lewis and Sahrmann (#1 PT mngment reference). Additionally, childhood problems such as Legg-Calve-Perthes disease, congenital hip dysplasia, and slipped femoral capital epiphysis have been correlated to labral tears (Schmerl et al). While most tears occur in the anteriosuperior quadrant, a higher than normal incidence of posterosuperior tears appear in the Asian population due to a higher tendency toward hyperflexion or squatting motions.<br>
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| == Characteristics/Clinical Presentation ==
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| == Differential Diagnosis ==
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| == Outcome Measures ==
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| add links to outcome measures here (also see [[Outcome Measures|Outcome Measures Database]])
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| == Examination ==
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| == Medical Management <br> ==
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| == Physical Therapy Management <br> ==
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| == Key Research ==
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| add links and reviews of high quality evidence here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br>
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| == Resources <br> ==
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| add appropriate resources here <br>
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| == Clinical Bottom Line ==
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| == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) ==
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| <br>
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| <br>
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| see tutorial on [[Adding PubMed Feed|Adding PubMed Feed]]
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| <div class="researchbox">
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| <div class="researchbox"><rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1XsgQGan4PZgSWV7lHuqOwoB3kVayOlxxIU5pMP5CwL_1jZck7|charset=UTF-8|short|max=10</rss></div>
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| </div>
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| == References ==
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| see [[Adding References|adding references tutorial]].
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| <references />
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| [[Category:Articles]] [[Category:Condition]] [[Category:Ankle]] [[Category:Musculoskeletal/Orthopaedics]] [[Category:Texas_State_University_EBP_Project]]
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