Hip labral tear without surgery

Hip labral tear non-surgical management: a conservative-first plan for pain, function, and activity

Senior woman in casual attire sitting on a couch holding a tablet in a cozy living room.

Non-surgical management of a hip labral tear means treating the hip without an operation. It uses activity changes, physical therapy, and pills or shots to control pain. It is checked on a set schedule, not left open-ended. A 2026 review calls non-operative care the first-line plan — activity changes, focused physical therapy, and select joint injections. It says to try conservative care for 6 to 12 weeks before surgery is even considered.10 The real question is not whether a tear shows on a scan. It is whether a structured trial is moving your pain and function the right way.

This page does something most hip labral tear pages skip. It names the patients the studies actually enrolled. It also names the patients they screened out. That matters if you have metabolic disease, obesity, or an inflammatory condition. It matters if you had surgery on the same hip, or pain that has lasted for years. Those are often the people a study rules out before it starts.

Key points

  • Three building blocks come first. Activity changes, physical therapy for hip mechanics and strength, and pills or shots when pain needs targeted control.2,3
  • Confirm the pain source before the trial starts. X-rays, plus a test injection when the source is unclear, keep you from spending months treating the wrong problem.4
  • Judge the plan on trends. Pain going down and function going up over months. Not one good or bad week.
  • Know who was studied. The 2023 systematic review behind the popular response rate left out osteoarthritis studies entirely. The one randomized trial left out dysplasia and severe joint-space loss. It also left out past surgery on the same hip and tears on both sides.5,9
  • “No consensus” is a voting outcome, not a finding. A 2025 doctor panel recorded no consensus on orthobiologics for labral tears without surgery. Yet 75% of the panel agreed or strongly agreed, and none strongly disagreed. That fell short of the 80% bar the study set in advance.4
  • Surgery is real, available, and not the opening move. Regen.MD provides surgery when conservative measures have been exhausted, after a full conservative trial.

Do you need surgery for a hip labral tear?

The labrum is a ring of tough cartilage on the socket side of the hip. A 2026 review says it is critical for hip stability. It keeps the suction seal and spreads load across the joint.10 When it is irritated or stressed, pain shows up in certain hip positions and under load. It is usually not constant.

A tear on a scan does not by itself prove you need an operation. Northwestern Medicine and NYU Langone Health both describe non-surgical care as the usual starting point for hip labral tears. That means activity changes, anti-inflammatory pills, physical therapy, and in-office shots.2,3

Do hip labral tears hurt all the time?

Pain generally tracks how the hip is loaded, not how bad the tear looks. Over time, pain changes how you walk and move. Those workarounds can keep the joint irritated instead of letting it calm down.

That is why non-surgical care is not just rest. It is a plan. It cuts the movements that set off pain. It rebuilds strength and control. It widens what your hip can do without a flare.

Why conservative care is revisited rather than abandoned

We look for trends, not perfection. Is pain going down? Is function going up? Can you do the things you care about with fewer flares? Those three answers drive the next step.

If progress stalls, we change the plan. We do not repeat it forever. The 2026 review is blunt here. Pain that stays or gets worse within the first 6-to-12-week window means the trial failed. It is not a reason to keep going unchanged.10 You can see how that step-by-step check works in our conservative-first evaluation pathway.

How is a hip labral tear diagnosed?

A conservative trial only works if it targets the right structure. In 2025, a panel of 40 sports medicine doctors weighed in. They published shared positions on how to work up and treat hip labral tears. They used a method called a modified Delphi consensus.4

Imaging that should be obtained up front

That panel agreed that every patient with a suspected labral tear should get X-rays. At minimum, that means a standing front view of the pelvis and a 45° Dunn view.4 These views show the bony shape of the hip. That is part of why two people with similar tears can need very different plans.

MRI and the role of contrast

Mayo Clinic says magnetic resonance arthrography makes a labral tear easier to see. This test is an MRI with contrast dye injected into the hip joint.1 A clearer diagnosis leads to more targeted care instead of a generic plan.

A diagnostic injection when intra-articular origin is uncertain

The same panel agreed on test injections too. If it is unclear whether pain comes from the hip joint, a diagnostic hip injection should be done. They also agreed steroid can be used when wear and tear is behind the pain.4 The 2026 review makes the same point. It says joint shots with numbing medicine, with or without steroid, do two jobs. They help find the source, and they ease pain for a short time.10

This matters for a conservative plan. It separates pain from inside the joint from pain made somewhere else. You learn that before you spend months rehabbing the wrong target.

The three building blocks of non-surgical management

NYU Langone Health names activity changes, medicine, and physical therapy as the treatments doctors may recommend for hip labral tears.2 Northwestern Medicine lists a similar core. That includes activity changes, rest, anti-inflammatory pills, and physical therapy that strengthens the core, spine, glutes, and hamstrings. It adds an ultrasound-guided shot into the hip joint when first steps do not work.3

Activity modification

The goal is to cut out the positions and loads that set off your pain. The goal is not to stop moving. NYU Langone Health puts it plainly: by avoiding these, you may be able to do many other activities without any symptoms.2

What exercises help a hip labral tear?

The 2025 panel reached strong consensus on the key parts of non-surgical treatment. Those are range of motion, strength, core work, and retraining everyday movement.4 What your hip can handle this month sets the starting point. Not a fixed protocol.

The panel did not agree on a calendar. All of them agreed there is no set time to start sport-specific training. That choice depends on strength, pain, and fear of the hip giving way.4 The 2023 systematic review found the same gap in the data. It saw no clear effect from how long or what kind of therapy, at very low to low certainty.5

Medication and injections for symptom control

NYU Langone Health says store-bought pain relievers may help ease hip pain. That includes acetaminophen and anti-inflammatory drugs like ibuprofen and naproxen.2 Northwestern Medicine describes in-office joint shots guided by ultrasound. These often hold a numbing agent with a small amount of steroid.3

The 2025 panel agreed that steroid shots have a role in labral tears. They help confirm the pain source and control symptoms.4 Shots used this way make rehab possible. They do not replace it.

How well does non-surgical treatment work for a hip labral tear?

Two numbers get quoted all the time on this topic. Both are real. Both come from groups narrower than the patients who walk into a regenerative medicine clinic. Read them without that context and you get the wrong expectation.

A 54% response rate, in a population where osteoarthritis was excluded

A 2023 systematic review with meta-analysis in the Journal of Orthopaedic & Sports Physical Therapy pooled 26 studies. Those studies covered 1,153 patients with hip pain but no arthritis. It found that 54% had a satisfactory response to non-surgical care (95% CI, 32% to 76%). The evidence was rated moderate certainty.5

Who was in that 1,153? The review used randomized trials and studies that followed patients forward. They covered hip impingement, a shallow hip socket called dysplasia, acetabular labral tear, and other hip pain without arthritis. It shut out studies of other joint problems inside the hip. It named slipped capital femoral epiphysis, Legg-Calvé-Perthes disease, avascular necrosis, and osteoarthritis. It also shut out look-back studies, case series, and case reports. It shut out studies with only an abstract, and studies not in English.5

So the 54% describes hips without established arthritis. If your X-rays show wear, the authors kept people like you out on purpose. That is not a knock on the review. It is a well-run review that answers a clearly defined question. It is a reason not to treat that number as your personal forecast.

“Satisfactory response” also had a set meaning in that review. It meant no surgery and/or no return of pain during follow-up. Or it meant feeling at least moderately better overall. Or it meant reaching the Patient Acceptable Symptom State on the daily-activities part of the Hip Outcome Score.5 So a patient who skipped surgery but still hurts can count as a success.

A 52-patient cohort where function improved and pain often did not

The second number comes from a 2019 case series in the American Journal of Sports Medicine. Researchers found 71 patients with labral injuries confirmed on MRI or arthrography. Each had at least a year of non-surgical care. Of those, 52 (73.2%) finished the one-year surveys. Mean follow-up was 16.2 months.6

All four function scores improved significantly. Yet 48.1% said their pain had not improved. And 69.2% were limited in their activities. And 40.4% were still weighing surgery. Even so, 71.2% were satisfied with non-surgical care overall.6

Now look at who they were. Mean age was 38.9 years. Their first X-rays showed minimal arthritis, Tönnis grades 0 to 2.6 The hospital’s summary of the same study reports a mean body mass index of 26. Mean symptom length was 19 months.7 That is a young group with little arthritis. Their weight sat near the low end of overweight. Their pain was measured in months, not years.

The authors drew the line plainly. The best fit for non-surgical care is likely a patient with minimal impingement. That patient is willing to change their lifestyle and accept some discomfort.7 That is advice about one kind of patient. It is not a general verdict.

The randomized trial, and the exclusion criteria behind it

The head-to-head evidence comes from one randomized trial run by a single surgeon. It compared hip arthroscopy with physical therapy alone. Patients were 40 and older with limited osteoarthritis (Tönnis grades 0 to 2). Ninety-seven patients were analyzed. Of those assigned to physical therapy alone, 71.1% crossed over to arthroscopy, at a mean of 5.10 months. At 24 months the surgery group scored better on nearly every measure. There was no significant difference between the groups in how many went on to total hip replacement.8

The trial’s registered rules list twelve reasons to exclude a patient. Patients were left out for less than 2 mm of joint space on standing X-rays. They were left out for developmental dysplasia of the hip. They were left out for Kellgren-Lawrence grade 4 changes and Tönnis grade 3 changes. They were left out for surprise findings during arthroscopy and for past surgery at the same site. They were left out for back pain worse than hip pain, or back pain with leg symptoms below the knee. They were left out for back pain with positive nerve-tension signs, and for knee pain worse than hip pain. They were left out for labral tears on both sides. They were left out for any reason they could not have surgery or physical therapy. And they were excluded for more than six weeks of another kind of physical therapy.9

Hold that list up against a real clinic schedule. Think of a hip with advanced joint-space loss or a shallow socket. Think of a hip that had surgery, tears on both sides, or a low back that adds to the pain. None of those patients would have been let in. Those rules are good trial design. They isolate one question. They also mean the trial never answered anything about those patients, either way.

What none of these designs could measure

Each study tested something narrower than the care a complex patient gets. The gaps are built into the design. They are not accidents.

None of them tested treatments together or in sequence. The randomized trial compared arthroscopy plus physical therapy against physical therapy alone. It did not test physical therapy plus metabolic care. It did not test a shot given before a loading program. A study of one treatment cannot report on combinations it never built.

Follow-up was also short for this problem. The meta-analysis drew its main pooled number from follow-up of 1 to 24 months. The case series ran a mean of 16.2 months. The randomized trial reported at 24 months.5,6,8 None of that measures how well results hold over the years a wearing hip has to last.

And each scoring tool only records what it was built to record. Hip surveys and pain scales do not track inflammation, blood sugar, or sleep. They miss the metabolic terrain under joint breakdown. So a study can be fully valid and still say nothing about whether addressing that terrain changes anything.

What a consensus statement is, and what “no consensus” means

The line most often quoted about orthobiologics and hip labral tears is that a doctor panel reached no consensus. That is accurate. It is also misread all the time. Most readers have never been told how a consensus statement is made.

How the panel was assembled and how agreement was counted

A consensus statement is not a trial. It makes no new data. It is a poll of chosen experts, run in rounds. They vote on proposed statements until the votes settle. The 2025 hip labral statement used a modified Delphi process with 40 sports medicine doctors. All had expertise in femoroacetabular impingement, a shape problem where the hip bones pinch. Half were 20 orthopedic surgeons who do hip arthroscopy. The other half were 20 non-surgical doctors. They split evenly into four groups. The groups were diagnosis, non-surgical care, surgical care, and rehab and return to play.4

The bars were set in advance. Agreement of 80% to 89% counted as consensus. Agreement of 90% to 99% counted as strong consensus, and 100% as unanimous consensus. Anything under 80% was recorded as no consensus.4

The authors are frank about this. Their limits section says consensus statements count as level 5 data, which is expert opinion. It says there was no standard process for writing the study questions. And it says the Delphi process itself may be filtered-down expert opinion.4 That is the authors judging their own paper.

The orthobiologics vote, in full

The non-surgical group was asked a question. Is there a role for orthobiologics in treating labral tears without surgery? If so, which ones and how often? The statement put to a vote read: there is a role for platelet-rich plasma and viscosupplementation in the non-operative management of labral tears.4

The votes were 0% strong disagreement, 3% disagreement, 22% neutral, 64% agreement, and 11% strong agreement. Consensus level: none.4

So 75% of a panel split evenly between hip surgeons and non-surgical doctors agreed or strongly agreed. Only 3% said no. Not one said strongly no. The statement failed because 75% is below 80%. It also failed because about a fifth of the panel sat neutral. The question asked them to name which product and how often. The published evidence does not yet let anyone name that level of detail.

Why absence of consensus is not evidence of absence

A panel recording “none” means the experts missed a preset voting bar. A negative trial means a treatment was tested against something else and did not beat it. These are different claims. Only the second is evidence that something does not work.

The 2023 systematic review reached the same place from the data side. Its authors say there was not enough evidence for firm advice on several options. Those were viscosupplement shots, steroid shots, orthobiologic shots outside of surgery, bracing, pills, and care for related psychological distress.5 Not enough evidence to recommend is not evidence against.

The honest summary is narrower and more useful than hype or dismissal. For hip labral tears, orthobiologics are not established, not disproven, and not routine.

Where orthobiologics fit, and where the evidence stops

Regen.MD is a regenerative and longevity medicine practice. So patients ask about platelet-rich plasma, bone marrow aspirate concentrate, and micro-fragmented adipose for hip pain. The answer has to meet our sourcing standard. That means saying what is known and what is not.

What the reviews say right now

The 2026 review says evidence for orthobiologics such as platelet-rich plasma and bone marrow aspirate concentrate is still limited and heterogeneous. It says routine use is not currently supported.10 That is a real caution, and we do not soften it here.

“Heterogeneous” is doing specific work in that review. It means the studies are not alike. Products differ by platelet level and white cell count. They differ in how they are made and how much is injected. They differ in how the needle is guided and how many shots are given. Patients differ by age, arthritis grade, and other illness. Small studies of different products in different patients do not add up to a clean answer. That is why the evidence is called unsettled, not negative. It is also why no orthobiologic has been shown to repair or regrow labral tissue. We make no such claim here.

A randomized comparison in a population most labral trials exclude

Developmental dysplasia of the hip is on the exclusion list of the randomized labral tear trial above.9 It is worth knowing what happens when that excluded group is studied on its own.

A 2025 double-blind randomized trial enrolled 42 patients with hip osteoarthritis caused by developmental dysplasia of the hip. It compared platelet-rich plasma shots into the joint against hyaluronic acid over 24 weeks. Both groups improved significantly from where they started. The platelet-rich plasma group improved more on the pain visual analog scale (38.5 versus 18.7, P = .041). But the gap on the WOMAC pain score was not statistically significant (4.3 versus 2.9, P = .245). The authors concluded that platelet-rich plasma is at least as effective as hyaluronic acid for this use.11

Two things follow, and both need saying. That trial studied hip osteoarthritis from dysplasia, not labral tears. So it does not tell you what platelet-rich plasma does for a torn labrum. Its design also limits it: 42 patients, 24 weeks, an active comparison instead of placebo, and two pain scores that disagreed. What it does show is this. A group screened out of one trial can be studied on its own. Here the result was modest and mixed, not absent.

How this is discussed at Regen.MD

Entry is a physician-led Clinical Evaluation. For a hip labral tear, we review your X-rays and MRI. We find out if the pain comes from inside the joint. We also check your metabolic and inflammation picture next to the scans. Here is why. The 2025 panel all agreed on a list of factors that shape results. It includes other illnesses, obesity, how long pain has lasted, joint wear, and failed past rehab.4 The 2026 review also links a higher body mass index and major cartilage damage to worse results.10

When orthobiologics come up, we describe them as what they are today. For this diagnosis they are options with limited and varied evidence. They are used together with a loading program, not in place of one. We write down the reasons for or against them. Nothing above is a promise of a certain result. You can see what each product is on our orthobiologics service page.

“My ethos is to treat all of my patients as I would my own family, with the goal of giving them back their quality of life.” — Dr. Gurpreet Singh Padda, MD, MBA, MHP

Coverage is a payer decision, not a clinical finding

Northwestern Medicine notes that steroid may not be advised in young people. It says other shot options include special forms of platelet-rich plasma or hyaluronic acid. It adds that most insurance carriers often do not cover these.3

Non-coverage is a payer’s decision about payment. It is not a scientific finding. Do not read it as one in either direction. Patients sign an advance beneficiary notice for services a payer does not cover. We discuss the medical reasons separately from the billing question.

When non-surgical management is not enough

A conservative trial is the right first step for many patients and the wrong one for some. If pain stays despite a well-built trial, we reopen the evaluation. We do not just extend the trial by default.

The panel all agreed on what to weigh when judging the odds that surgery will work. The list was age, pain severity, mental health, other illness, and obesity. It also listed failed past rehab and how long pain has lasted. It also included pincer lesion, cam lesion, joint wear, dysplasia, motivation, and workers’ compensation.4 The 2026 review adds two warning signs. One is a joint space under 2 mm. The other is Tönnis grade 2 osteoarthritis. Both are linked to significantly higher rates of total hip replacement later.10

Regen.MD does provide surgery when conservative measures have been exhausted, and Dr. Gurpreet Singh Padda, MD, MBA, MHP is a surgeon. Surgery follows a full conservative trial. It is not the opening move. We name the factors above for one reason. We want to decide honestly which patients a longer trial will likely help.

For more information, get our free guide to knee pain and treatment options.

Frequently asked questions

What does non-surgical management for a hip labral tear usually include?

It usually combines activity changes, physical therapy for hip mechanics and strength, and pills or shots when pain needs targeted control. It is rechecked on a schedule. If your case does not fit a simple labral pattern, the evaluation widens; see the conditions we evaluate.

How long should I give conservative treatment before deciding it has failed?

A 2026 review advises a first conservative trial of 6 to 12 weeks before surgery is considered. Pain that stays or gets worse in that window means the trial failed. It is not a reason to extend it. Published results for hip pain without arthritis are reported over months, not weeks. That is why we judge progress on trends in pain and function. Background reading is collected in the Regen.MD library.

Can PRP or another orthobiologic fix a hip labral tear?

No orthobiologic has been shown to repair or regrow labral tissue. A 2026 review says evidence for platelet-rich plasma and bone marrow aspirate concentrate is still limited and varied. It says routine use is not currently supported. A 2025 doctor panel recorded no consensus on orthobiologics for non-surgical care. Still, 75% of that panel agreed or strongly agreed and none strongly disagreed, short of its 80% bar. We discuss these products during evaluation as options with clear limits. The types are described on our orthobiologics service page.

Do these studies apply to me if I have diabetes, obesity, or a previously operated hip?

Often not directly. The 2023 meta-analysis left out arthritis studies. The randomized trial left out dysplasia, severe joint-space loss, past surgery on the same site, and tears on both sides. The 52-patient group had a mean age of 38.9 years with minimal arthritis. So a result of no effect, or only a modest one, in those groups does not tell you what happens to the patients they left out. That is why we review your metabolic and inflammatory data next to your scans, in person at our St. Louis clinic.

Who reviews my case at Regen.MD?

Evaluation is physician-led. Entry is a Clinical Evaluation that reviews your history, scans, and metabolic data before any procedure is proposed. You can read about the doctor who leads that review at Dr. Gurpreet Singh Padda, MD, MBA, MHP.

What can be mistaken for a torn hip labrum?

Pain that starts outside the hip joint can look like a labral tear. A low back that adds to hip pain is one example. A tear that shows up on a scan does not decide the plan by itself. That is why we use a test injection when the source is unclear. It separates pain inside the joint from pain coming from somewhere else. You learn that before months of rehab go to the wrong target.

What activities should I avoid with a hip labral tear?

Avoid the specific positions and loads that set off your pain. Do not avoid movement in general. The goal is to remove those triggers. Then you can keep doing many other things without pain. Physical therapy then rebuilds range of motion, strength, core control, and everyday movement. It starts from what your hip can handle this month, not a fixed protocol.

Do I need an MRI for a hip labral tear?

Start with X-rays. A 2025 doctor consensus agreed every patient with a suspected labral tear should get them. At minimum that means a standing front view of the pelvis and a 45° Dunn view. That is because the bony shape of the hip changes the plan. An MRI with contrast dye injected into the joint, called MR arthrography, makes a labral tear easier to see.

Find out what is actually driving your hip pain

Regen.MD begins with a physician-led Clinical Evaluation — a review of your history, imaging, and metabolic data, and a written terrain roadmap. Evaluation is contingent upon review of your data.

Apply for Clinical Evaluation

Questions? Call or text us.

Sources

  1. Mayo Clinic. Hip labral tear — Diagnosis & treatment. https://www.mayoclinic.org/diseases-conditions/hip-labral-tear/diagnosis-treatment/drc-20354878 (Referenced for: MR arthrography with contrast material injected into the hip joint space.)
  2. NYU Langone Health. Medical Treatment & Activity Modification for Hip Labral Tears. https://nyulangone.org/conditions/hip-labral-tears/treatments/medical-treatment-activity-modification-for-hip-labral-tears (Referenced for: activity modification and participation in other activities without symptoms; acetaminophen and NSAIDs including ibuprofen and naproxen; physical therapy.)
  3. Northwestern Medicine. Hip Injury Repair — Nonsurgical Treatment. https://www.nm.org/conditions-and-care-areas/treatments/hip-injury-nonsurgical-treatment (Referenced for: activity modification, rest, oral anti-inflammatory medication, targeted strengthening of core, spine, glutes and hamstrings; ultrasound-guided intra-articular injection with 1 percent lidocaine and a small amount of steroid; platelet-rich plasma or hyaluronic acid alternatives in young individuals and their frequent non-coverage by insurance carriers.)
  4. Matache BA, Belzile ÉL, Ayeni OR, et al.; AAC-CASEM Consensus Group. Management of Labral Tears in the Hip: A Consensus Statement. Orthopaedic Journal of Sports Medicine. 2025;13(1):23259671241305409. doi:10.1177/23259671241305409. https://pmc.ncbi.nlm.nih.gov/articles/PMC11758551/ (Referenced for: 40-physician modified Delphi panel, 20 AAC orthopedic surgeons and 20 CASEM non-operative physicians in four working groups; consensus thresholds of 80–89%, 90–99% and 100%; standing AP pelvis and 45° Dunn radiographs; diagnostic injection when intra-articular origin is uncertain; corticosteroid injection consensus; key components of non-operative treatment; no fixed time point for sport-specific training; orthobiologics question wording and vote distribution 0/3/22/64/11 with consensus level none; unanimous prognostic-factor list; level 5 expert-opinion limitations.)
  5. Probst DT, Sookochoff MF, Harris-Hayes M, Prather H, Lipsey KL, Cheng AL. What is the Rate of Response to Nonoperative Treatment for Hip-Related Pain? A Systematic Review With Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2023;53(5):286–306. doi:10.2519/jospt.2023.11666. https://pmc.ncbi.nlm.nih.gov/articles/PMC10176100/ (Referenced for: 54% response rate, 95% CI 32%–76%, moderate certainty, across 26 studies and 1,153 patients with non-arthritic hip-related pain; study selection criteria and the explicit exclusion of osteoarthritis and other intra-articular hip disorders; responder definition; absence of a definitive effect for therapy duration or approach; insufficient evidence regarding orthobiologic injection outside an operative setting.)
  6. Quinlan NJ, Alpaugh K, Upadhyaya S, Conaway WK, Martin SD. Improvement in Functional Outcome Scores Despite Persistent Pain With 1 Year of Nonsurgical Management for Acetabular Labral Tears With or Without Femoroacetabular Impingement. American Journal of Sports Medicine. 2019;47(3):536–542. doi:10.1177/0363546518814484. https://pubmed.ncbi.nlm.nih.gov/30557033/ (Referenced for: 71 patients identified and 52 (73.2%) completing follow-up; mean follow-up 16.2 months; mean age 38.9 years; Tönnis grades 0–2; 48.1% no pain improvement, 69.2% activity-limited, 40.4% considering surgery, 71.2% satisfied; case series, level of evidence 4.)
  7. Massachusetts General Hospital, Advances in Motion. Nonsurgical Treatment of Hip Labral Tears Improves Function, but Pain Can Persist. 2019. https://advances.massgeneral.org/ortho/journal.aspx?id=1273 (Referenced for: institutional summary of the above study, including average BMI 26 and average symptom duration 19 months, and the authors’ statement on which patients are best suited to non-surgical management.)
  8. Martin SD, Dean MC, Gillinov SM, et al. Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: 24-Month Results From a Randomized Controlled Trial. American Journal of Sports Medicine. 2024;52(10):2574–2585. doi:10.1177/03635465241263595. https://pubmed.ncbi.nlm.nih.gov/39101607/ (Referenced for: single-surgeon randomized controlled trial in patients aged 40 and older with Tönnis grades 0–2; 97 patients analyzed; 71.1% crossover at a mean of 5.10 months; superiority of arthroscopy plus physical therapy at 24 months; no significant difference in arthroplasty conversion.)
  9. ClinicalTrials.gov. Arthroscopic Labral Repair Versus Physical Therapy for Tears of the Acetabular Labrum in Patients Age 40 and Older. NCT03909178, Massachusetts General Hospital. https://clinicaltrials.gov/study/NCT03909178 (Referenced for: the registered inclusion criteria and the twelve exclusion criteria quoted in the text.)
  10. Brinkman JC, Kunze KN, Monty TL, Sparks CA, Malloy P, Chahla J, Nho SJ. The Management of Acetabular Labral Tears: A Contemporary Review. Current Reviews in Musculoskeletal Medicine. 2026;19(1):52. doi:10.1007/s12178-026-10035-w. https://pmc.ncbi.nlm.nih.gov/articles/PMC13291315/ (Referenced for: labral function in stability, suction seal and load distribution; non-operative care as first line; 6–12 week initial conservative trial and treatment failure within that window; diagnostic intra-articular injections; orthobiologic evidence limited and heterogeneous with routine use not currently supported; joint space under 2 mm and Tönnis grade 2 associated with higher arthroplasty conversion; higher BMI and significant chondral damage associated with inferior outcomes.)
  11. Okanoue Y, Ikeuchi M, Dan J, Teranishi Y. Effectiveness of platelet-rich plasma in pain management of osteoarthritis with developmental dysplasia of the hip: a double-blind, randomized controlled trial. Journal of Hip Preservation Surgery. 2025;12(4):230–236. doi:10.1093/jhps/hnaf008. https://pmc.ncbi.nlm.nih.gov/articles/PMC12712949/ (Referenced for: 42 patients, PRP versus hyaluronic acid, 24 weeks; pain-VAS improvement 38.5 versus 18.7, P = .041; WOMAC-pain 4.3 versus 2.9, P = .245; conclusion that PRP is at least as effective as hyaluronic acid in this population.)
  12. Theige M, David S. Nonsurgical Treatment of Acetabular Labral Tears. Journal of Sport Rehabilitation. 2018;27(4):380–384. doi:10.1123/jsr.2016-0109. https://pubmed.ncbi.nlm.nih.gov/28253054/ (Referenced for: a critically appraised topic of four studies in athletes with confirmed acetabular labral tears; highest level of evidence achieved was 4; strength of recommendation level 3; the authors’ caution that the approach should not be applied to every athlete given the low strength of current research.)
  13. Enseki K, Harris-Hayes M, White DM, et al.; Orthopaedic Section of the American Physical Therapy Association. Nonarthritic Hip Joint Pain: Clinical Practice Guidelines. Journal of Orthopaedic & Sports Physical Therapy. 2014;44(6):A1–A32. doi:10.2519/jospt.2014.0302. https://pmc.ncbi.nlm.nih.gov/articles/PMC4399382/ (Referenced for: clinical practice guideline framing of non-arthritic hip joint pain.)
  14. Enseki KR, Bloom NJ, Harris-Hayes M, et al. Hip Pain and Movement Dysfunction Associated With Nonarthritic Hip Joint Pain: A Revision. Journal of Orthopaedic & Sports Physical Therapy. 2023;53(7):CPG1–CPG70. doi:10.2519/jospt.2023.0302. https://pubmed.ncbi.nlm.nih.gov/37383013/ (Referenced for: the 2023 revision that updates and supersedes the 2014 guideline above.)