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Advanced Orthopedic Specialists

2305 Genoa Business Park Dr.; Suite 170; Brighton, MI 48114; Phone: (810) 299-8550; F: (810) 844-0837

Appointments

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Contact us today to make an appointment to see a doctor, or for physical therapy.

Advanced Orthopedic Specialists
(810) 299-8550

Physical Therapy
(810) 299-8557

Physicians
To refer a patient, complete our patient referral form.

Post-Op Information

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Below are some quick links to important post-operative information.

Cast Care

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Take care of your cast, so your cast can take care of you.

Locations & Directions

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Our office is located in Brighton, Michigan on the 1st floor of the Genoa Medical Center Building.

Address:
2305 Genoa Business Park Dr.
Suite 170
Brighton, MI 48114

Dr. Mihalich sees patients on a limited basis in Novi.

Address:
The Novi Orthopaedic Center, and
The Bone & Joint Center of Novi
26750 Providence Pkwy., Ste. 210
Novi, MI 48374

See our location page for maps, directions and photos.

Hip Labral Tears

Location of the labrum around the hip joint. Labral tears cause groin pain, popping, clicking and catching and can be treated arthroscopically or without surgery. Image in public domain and not under copyright. Location of the labrum around the hip joint. Labral tears cause groin pain, popping, clicking and catching and can be treated arthroscopically or without surgery.

Tears of the hip labrum (acetabular labrum) are increasingly common causes for hip pain in teenagers through adults in middle age.

The hip is a ball and socket joint. The labrum is an "O-ring" cartilage around the socket. It can become torn for a variety of reasons, but the most common is femoroacetabular impingement, wherein bone spurs on either the femur (ball) or acetabulum (socket) rub on the labrum and cause it to tear. Other causes of labral tears include trauma or arthritis. Traumatic tears are usually caused by planting the leg on the ground and twisting; more major trauma such as motor vehicle accidents can also tear the labrum. As people develop arthritis, they can also develop labral tears.

Evaluation

Symptoms of a hip labral tear include pain in the groin, clicking/popping, or catching of the hip. Sometimes the pain is not limited to the groin and can be on the side of the hip, or in the posterior buttocks area.

Diagnosis is made by obtaining a patient history, performing a physical examination, obtaining plain X-rays, and often, an MRI arthrogram (in which a contrast dye is injected into the hip prior to performing the MRI). Unfortunately, even the most sensitive test for labral tears can sometimes be negative, and the diagnosis is made clinically.

Treatment

Non-operative treatment includes non-steroidal anti-inflammatory medications (NSAIDs), injections, physical therapy, and rest from aggravating activities. Unfortunately, in many cases, non-operative treatment is not successful for this mechanical problem and surgery is necessary. While open surgery is an option, it involves large incisions and many risks of complications. We recommend arthroscopic hip surgery for patients who do not have significant amounts of arthritis.

Arthroscopic surgery consists of either trimming the torn labrum or a repair of the labrum (i.e., sewing it back to the acetabulum). Generally, we prefer to repair the labrum when at all possible, by suturing the torn labrum to small plastic anchors placed in the acetabular rim. However, many tears are smaller tears, or "shredded" and in those cases, simply trimming the torn tissue provides good symptom relief. Furthermore, most labral procedures are accompanied by other procedures such as femoroplasty or acetabular rim trimming, to treat the underlying femoroacetabular impingement cause of the tear.

Arthroscopic hip surgery typically takes 45 to 90 minutes, and is performed on an outpatient basis. Patients are asked to use crutches for three (3) weeks with partial (50%) weight-bearing. Patients will start early range of motion during these three weeks, and some patients will even use a stationary bike during this time. After three (3) weeks, full weight bearing is initiated. At approximately six (6) weeks post-operative, patients may begin physical therapy (if necessary), and jogging on a treadmill. We usually recommend avoidance of twisting sports for at least three (3) months. Relief of pain is variable — some patients note almost immediate relief of pain. Most patients have excellent symptomatic relief by three (3) months post-operative. Some patients may take up to six (6) months to note improvements of symptoms, especially if they had repair of a larger tear, or other procedures such as microfracture.

Our Dr. Farjo has been an expert on these tears for more than a decade and published one of the first pivotal studies on the arthroscopic treatment of labral tears, which has been cited widely by most subsequent research on this disorder. He has created a video for patients demonstrating the modern arthroscopic treatments available for these tears. Please see video below:

Technology

We have invested hundreds of thousands of dollars to ensure our patients receive state-of-the-art care with the latest available technology, taking your orthopedic care to a whole new level.

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Physical Therapy

Our physical therapy suite has more than 4000 square feet to serve you better! The goal of our program is a faster and better recovery from orthopedic problems.

Privacy Policy

We are currently compliant with all provisions of the Health Insurance Portability and Accountability Act. Please read our privacy policy for more details.

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DISCLAIMER: This site and information herein is provided for informational purposes only. It is not designed to diagnose, treat, or cure any problem. We cannot give out specific medical advice over the internet; if you wish to make an appointment for an evaluation of your particular problem, please contact us.