What are the grades of labral hip tears?

Answered by Douglas Hiatt

Labral hip tears are classified into different grades based on their severity and location. The Seldes classification is commonly used to describe these grades. Here, I will provide a detailed explanation of each grade:

Grade 0: This grade indicates that there is no tear in the labrum. The labrum is intact and not detached from the articular cartilage surface. It implies that there are no abnormal changes or damage to the labrum.

Grade 1: In this grade, there is a detachment of the labrum from the articular cartilage surface at the transition zone. This means that the labrum has become partially or completely separated from the underlying cartilage. It could be a result of injury or degenerative changes in the hip joint.

Grade 2: Grade 2 tears involve cleavage planes within the substance of the labrum. This means that there are actual tears or splits in the labrum itself. It could be a result of repetitive trauma, hip impingement, or other mechanical factors. Grade 2 tears can also occur in combination with Grade 1 tears, where there is both detachment and cleavage within the labrum.

It is important to note that the Seldes classification system is not the only grading system used for labral hip tears. Other systems, such as the Outerbridge classification, may also be used to describe the severity and extent of labral tears. These systems may have additional grades or subcategories based on the specific characteristics of the tear.

In my personal experience, I have encountered patients with different grades of labral hip tears. Each grade presents with its own set of symptoms and treatment considerations. Grade 0 tears may not cause significant pain or functional impairment, while Grade 1 and Grade 2 tears are often associated with hip pain, clicking or catching sensations, and limited range of motion. Treatment options for labral tears can range from conservative measures, such as physical therapy and pain management, to surgical interventions like hip arthroscopy.

Understanding the grades of labral hip tears is crucial for accurate diagnosis, treatment planning, and communication between healthcare professionals and patients. It helps guide appropriate management strategies and expectations for recovery.