Summary A hip labral tear is a traumatic tear of the acetabular labrum, mostly common seen in acetabular dysplasia, that may lead to symptoms of internal snapping hip as well hip locking with hip range of motion. Diagnosis generally requires an MR arthrogram of the hip joint in question. Treatment is a nonoperative trial to include NSAIDs, rest and physical therapy. Arthroscopic labral debridement versus repair is indicated for patients with progressive symptoms who failed nonoperative management. Epidemiology Incidence highest incidence in patients with acetabular dysplasia Demographics seen in all age groups patients commonly active females Anatomic location anterosuperior labrum most common location Etiology Pathophysiology femoroacetabular impingement hip dysplasia floppy labrum more susceptible to tearing trauma hip dislocations/subluxations are a common cause capsular laxity increased translational forces across labrum due to joint hypermobility joint degeneration causes acetabular edge loading Anatomy Structure horse-shoe shaped structure continuous with transverse acetabular ligament 2 parts articular login to view 1 more bullet capsular login to view 1 more bullet Vascularity capsule and synovium at acetabular margin only peripheral 1/3rd of the labrum is vascularized Innervation highly innervated with mechanoreceptors and nocioreceptors branch of nerve to the quadratus femoris obturator nerve Presentation Symptoms mechanical hip pain and snapping may have vague groin pain may be associated with a sensation of locking Physical exam provocative tests anterior labral tear login to view 1 more bullet posterior labral tear login to view 1 more bullet Imaging Radiographs useful to exclude other types of hip pathology may show hip dysplasia arthritis acetabular cysts MRI arthrogram imaging study of choice 92% sensitive for detecting labral tears may be combined with intra-articular injections of lidocaine and steroid for diagnostic and therapeutic purposes Treatment Nonoperative rest, NSAIDS, physical therapy, steroid injections indications login to view 1 more bullet outcomes login to view 1 more bullet Operative arthroscopic labral debridement indications login to view 2 more bullets technique login to view 5 more bullets outcomes login to view 2 more bullets arthroscopic labral repair indications login to view 2 more bullets outcomes login to view 1 more bullet labral reconstruction indications login to view 1 more bullet outcomes login to view 1 more bullet