November 2024

ORTHOPAEDICS

CASE REPORT: FEMOROACETABULAR IMPINGEMENT WITH A DETACHED LABORAL TEAR

Featuring: Sanjeev Bhatia, MD
​A 56-year-old active woman, a marathon runner, presented with femoroacetabular impingement (FAI) and a detached labral tear.

Advanced imaging, including MRI, confirmed the tear. After conservative treatments failed, an ultrasound-guided steroid injection was administered into the patient’s hip for temporary relief. When pain returned shortly after, the patient and their care team, including Sanjeev Bhatia, MD, decided to pursue hip arthroscopy.

During the Hip Arthroscopy
  • The joint was gently distracted using air and water so the team could insert a scope for evaluation.
  • The team noted that the patient had excellent cartilage quality throughout her hip, with no evidence of arthritis.
  • They confirmed detached labral tear as the source of her symptoms.
  • The care team used an arthroscopic bur to smooth down subtle bone spurs on the rim of the hip socket.
  • Then, they repaired the detached labral tear by suturing it back to the rim of the hip socket with small suture anchors.

Takeaways
FAI and labral tears can develop due to subtle asymmetries in the hip joint, causing the labrum to pinch and detach. Labrum detachment can lead to significant pain. Dr. Bhatia stresses the importance of early diagnosis and appropriate management of FAI and labral tears, and he recommends referral to an orthopaedic specialist for persistent hip pain.
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The patient’s goal was to run in the Tokyo 2024 Marathon six months post-surgery, and, with a dedicated rehabilitation team, she resumed running and achieved her goal. 
 Sanjeev Bhatia, MD, orthopaedic surgeon at Northwestern Medicine and director of the Hip and Knee Joint Preservation Center​

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