Nonsurgical Treatment of Acetabular Labrum Tears: A Case Series

STUDY DESIGN: Case series. BACKGROUND: While the literature has emphasized surgical treatment of acetabular labrum tears, there is a lack of information regarding conservative treatment. The purpose of this case series was to describe a nonsurgical program for those with clinical evidence of an acetabular labrum tear, that emphasized hip and lumbopelvic stabilization, correction of hip muscle imbalance, biomechanical control, and sport-specific functional progression. CASE DESCRIPTION: The 4 patients in this series had clinical evidence and magnetic resonance imaging confirmation of an acetabular labrum tear and underwent a similar treatment protocol consisting of 3 phases. Phase 1 emphasized pain control, education in trunk stabilization, and correction of abnormal joint movement. Phase 2 focused on muscular strengthening, recovery of normal range of motion (ROM), and initiation of sensory motor training. And phase 3 emphasized advanced sensory motor training, with sport-specific functional progression. ROM, flexibility, pain, special tests, and level of function were assessed, and strength was measured with handheld dynamometry. OUTCOMES: All patients demonstrated decreased pain, functional improvement, and correction of muscular imbalance. Increased muscle strength, primarily for the hip flexors (1%-39%), abductors (18%-56%), and extensors (68%-139%) was also noted. DISCUSSION: All patients responded well to our program. This case series suggests that patients with clinical evidence of an acetabular labral tear confirmed with MRI can show meaningful improvement with nonsurgical intervention. LEVEL OF EVIDENCE: Therapy, level 4. J Orthop Sports Phys Ther 2011;41(5):346-353, Epub 18 February 2011. doi:10.2519/jospt.2011.3225