New York, NY—July 1, 1999
Most people have heard of a torn cartilage in the knee. A tear in the soft tissue of the hip joint, called the labrum, may not be as common, but can still cause serious problems for many people, according to Dr. Robert Buly, an orthopedic surgeon at Hospital for Special Surgery. Just ask Suzanne Oshry. A television writer from California who once climbed the Himalayan Mountains, she suffered for seven years and saw half a dozen doctors until Dr. Buly diagnosed her problem -- a labral tear.
The labrum is the fibrous cartilage that runs around the bony rim of the hip socket - kind of like a gasket - that serves to cushion the joint. If it tears, often the result of an injury, it can spell trouble -- pain, catching in the joint and limited range of motion for patients. The injury can severely restrict a patient’s activities. An action as simple as getting out of a car can become a tremendously painful task when someone has a labral tear. The discomfort is usually in the inner hip area.
"For seven years, not a day went by that I didn’t feel that pain," Suzanne recalls. "It felt like something was catching in the joint -- a 10-second shot of pain that was almost immobilizing. It happened if I crossed my legs, got out of a car, sometimes seven to 10 times a day." Suzanne sought help from numerous physicians, trying everything from physical therapy to acupuncture and massage. The pain always came back. "Some doctors said it was in my head. I had almost given up hope of finding an answer," she said. Then she was referred to Dr. Buly.
"Suzanne’s problem was similar to that of many of the patients who come to us," said Dr. Buly. "Most MRI’s don’t pick up a labral tear and it can go undiagnosed for years. As the joint deteriorates and the pain worsens, some people even end up with a hip replacement."
In Suzanne’s case, high-resolution, specially sequenced MRI’s performed at HSS left no doubt about the diagnosis. "When Dr. Buly examined me, he knew exactly where the pain would be," Suzanne recalls. "My reaction was, 'oh thank you, someone finally knows what I’m talking about.'"
Dr. Buly performed arthroscopic surgery to repair the torn labrum, with the help of a laser. The minimally invasive procedure allows for less pain and a quicker recovery, according to Dr. Buly, with some patients able to go into physical therapy and leave the hospital the day of surgery.
Suzanne stayed at the hospital overnight, and the next day, in physical therapy, she was hopeful that her seven-year ordeal was over. "This is the first day since 1992 that I have not had that pain," she said. Suzanne added that she looks forward to getting back to an active lifestyle that had been on hold. She’s anxious to go horseback riding and salsa dancing.
Although a labral tear is not as common as torn cartilage in the knee, there may be many cases hip experts never see because it often goes undiagnosed. Dr. Buly has found that patients desperate for relief often log on to the internet in search of answers. A musician from California and a science teacher/skydiver from Pennsylvania both found out about Dr. Buly on the HSS website and came to him for help. The women, both in their early thirties, had labral tears that had gone undiagnosed for several years. After arthroscopic surgery, they’ve both been able to resume a pain-free and active lifestyle.
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