Understanding Hip Labrum Injuries in the NBA

• Post By: Jeff Stotts
• Date: November 18, 2015
• Category: Injury Report, NBA

The Washington Wizards announced Tuesday that forward Martell Webster will undergo surgery on a partial tear in the labrum of his right hip and miss the remainder of the season. The news comes less than a week after Yahoo’s Adrian Wojnarowski reported forward Wilson Chandler would also miss the season due to a torn hip labrum. The surgeries for Webster and Chandler mark the fourth and fifth hip surgeries needed by NBA players since July, the highest occurrence rate over the last 10 seasons.

NBA fans are more familiar with labrum tears of the shoulder. Cleveland’s Kevin Love infamously tore the labrum of his glenohumeral joint during last year’s postseason, joining a long list of players to suffer the injury including Carmelo Anthony, Dwyane Wade, and Dwight Howard. Similarly, the hip is stabilized by its own fibrocartilage labrum but, like its shoulder counterpart, it is susceptible to injury.

The primary joint in the hip is known as the acetabulofemoral (AF) joint. The AF joint is what most people refer to as the hip socket and for good reason. The joint is classified as a ball-and-socket joint, just like the shoulder. Ball-and-socket joints resemble a golf ball on a tee. In the AF joint, the head of the large upper leg bone known as the femur (the golf ball) sits in the acetabulum of the pelvis (the tee). The ball (head of the femur) can freely pivot on the tee (acetabulum) allowing for a large amount of mobility. This high degree of freedom comes at the cost of stability, which is where the labrum comes into play. The labrum deepens the acetabulum without overly restricting motion at the area. The surrounding musculature and numerous ligaments work with the labrum to further stabilize the hip. Unfortunately a violent collision or excessive repetitive motion can cause the labrum to fray or tear. Anatomical variance in the head of the femur can also contribute to the problem, resulting in an impingement of the labrum. These injuries are very painful and often result in limited mobility. If left untreated chronic instability in the hip can develop.

Surgery remains the most proactive approach to treatment. The exact procedure depends on the root of the problem. An acute tear can be repaired or smoothed down, similar to the way a meniscus injury is addressed. If an impingement issue is the problem, the defect or bone spur will be trimmed or removed in a debridement. A microfracture procedure may even be performed to help stimulate cartilage repair. Those with congenital problems, like Portland’s Gerald Henderson, may ultimately require surgery on both hips.

The sudden increase in hip surgeries is a bit alarming given the severity of the injury and the extended treatment time associated with surgery. Part of the reason for the sudden increase in diagnoses may simply be medical professionals are more keenly aware of femoroacetabular impingement and other congenital problems. However identifying any other contributing factors could go along way in preventing any additional hip labrum cases before they occur.