Peter Attia· MD
now in the shoulder the labrum creates effectively the socket so if you have a person who's never had a subluxation of their shoulder um you know that that labrum is creating kind of a vacuum around the glenoid head this seems to be a much more stable ball and socket than the shoulder what is the role of the labrum in stabilizing that joint I can understand how asymmetries can cause arthritis but just in terms of pure stability right um You don't really hear about dislocations of the hip very often obviously the most famous example I can think of is Bo Jackson right um which maybe we can talk about that case a bit but um what is it that the labrum is doing from a stability standpoint or is it simply just providing a clean and neutral articulating surface for the cartilage it it it also helps to create a seal around the ball so it is a sort of a suction effect too and it's very similar to the shoulder we have Dynamic stabilizers in the hip it becomes more of a concern when the hip isn't formed normally because then that acetabulum becomes flatter which actually mimics the shoulder a little bit in terms of lack of stability correct and some of those patients who have instability of the hip because maybe they have some dysplasia so the ball never really is in the hip they have greater motion and your ballet dancers would be a perfect example it comes at the cost of less stability that's right and some of those individuals who actually have a hypertrophic labrum it actually gets bigger because it's being asked to do more yeah there's also I mean you could see in the picture here there's a ligamentum Terriers I don't know if you remember that from Medical School only slightly it's uh it's basically called the round ligament and we didn't think it did that much it provides some blood supply early on in life and then later on doesn't really provide much blood but for people who are unstable this provides a secondary restraint because the ligament connects the ball to the socket so one thing we need to be aware of whenever you're operating on the hip is to leave that alone in individuals who are unstable because it's providing a bit of stability to that area got it is this um a good diagram to show how you do