Front of the Hip (Anterior/Groin)
Anterior hip pain is the most common area to experience true hip joint pain. Pain in the front of the hip could potentially be a groin strain acutely. Chronic groin pain particularly with sitting can be caused by a labral tear and/or impingement.
The hip joint has a cartilage ring around the socket portion of the ball and socket of the joint called the labrum. The labrum adds to the stability of the hip joint by making the socket deeper, however labral tissue in the hip can be torn from either repeated wear and tear or from a sudden injury or trauma.
A tear in the labrum of the hip causes pain in the joint and/or into the groin. It can also cause a popping or catching sensation deep in the joint. A forceful twisting injury or a traumatic hip dislocation can cause labral tears but usually hip labral tears are caused by a slow progressing chronic injury caused by the shape of the ball of the hip joint’s ball and socket not completely matching the concavity of the hip socket.
Certain athletes, such as golfers are more prone to hip labral tears due to the twisting motion of the hips with a drive. Dancers are also at risk, due to the extreme range of motion the hip joint is put through with extremely high kicks and leaps. In addition to a physical exam the final diagnosis needs to be done with an MRI of the hip joint.
Although conservative treatment such as injections or physical therapy can be tried first a labral tear of the hip usually requires surgery since the labrum does not have a good blood supply. In surgery, the tear can be repaired or debrided (trimmed/cleaned up) arthroscopically, often referred to as a hip scope. With a labral repair the torn area is repaired with stitches. In a debridement, the tear is trimmed away with removal of the torn parts.
During a hip scope the surface of the socket is often smoothed out during the surgery so the joint fits together better mechanically reducing the risk of future tears.