LABRAL INJURY
What is a Labrum?
The labrum is a ring of dense fibrocartilage that surrounds the socket of a ball and socket joint and stabilizes the joint thereby reducing risk of subluxation or dislocation. A healthy labrum helps to support and protect the joint and reduce pain and progression of osteoarthritis.
What joints have a labrum?
Labrum exist in ball and socket joints. The most common labrum discussed are those in the hip and the shoulder.
Why does the Labrum get injured?
The labrum is made of cartilage which is a soft tissue and it is between two bones which are hard. When you load, twist and or pivot the labrum is at risk of injury. You can pinch it between the two bones and bruise or tear it.
How common are labral tears?
Studies show by the age of 45-60 55-72% of asymptomatic individuals have shoulder labral tears on MRI. Other studies show that 25% of asymptomatic college athletes have shoulder labral tears in their 20’s. So shoulder labral tears are very common and do not always cause pain. Hip labral tears are also very common in asymptomatic individuals. Studies show in youth athletes with an average age of 15 that “89% of the participants 16 years of age or older had labral tears and 56% of the participants 16 years or younger had labral tears.” While these numbers seem astounding they are a reminder that the body is remarkably adaptable and frequently even when injury occurs, the body can modify and adapt to a pain free state.
References:
–High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders 2016
–Prevalence of MRI Shoulder Abnormalities in Asymptomatic Professional and Collegiate Ice Hockey Athletes 2020
–The prevalence of acetabular labral tears and associated pathology in a young asymptomatic population 2015
What if the labrum IS the cause of pain?
This is where proving that the labrum is the cause of pain is absolutely essential. If we feel strongly based on your history, clinical exam and MRI findings that the labrum IS in fact the source of your symptoms and you have failed to improve with > 6 weeks of excellent PT etc, then we inject Ropivicaine ( a non toxic anesthetic) into your shoulder or hip joint under ultrasound guidance and see how much of your pain resolves for 2-4 hrs. If > 80% of your pain goes away then we move ahead with a biologic injection to try to change the chemical environment of the joint and facilitate healing of the labrum
What is our success rate?
We have seen about an 85% success rate using PRP or BMAC for Labral tears.
How do I book a consult for my labral tear?
Click HERE to schedule a Teleconsult or In person Exam with Dr Esser.