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The role of the acetabular labrum in hip dysplasia. A literature overview.

ABSTRACT: A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should be treated before the periacetabular osteotomy (PAO), treated simultaneously with the PAO, or left alone and only treated if symptoms persist after the PAO. This review is an update of aspects of labral anatomy and function, the etiology of labral tears in hip dysplasia, and diagnostic assessment of labral tears, and we discuss treatment strategies for coexisting labral tears and hip dysplasia.

SUBMITTER: Hartig-Andreasen C

PROVIDER: S-EPMC3584604 | biostudies-literature | 2013 Feb

REPOSITORIES: biostudies-literature

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The role of the acetabular labrum in hip dysplasia. A literature overview.

Hartig-Andreasen Charlotte C Søballe Kjeld K Troelsen Anders A

Acta orthopaedica 20130123 1

A periacetabular osteotomy (PAO) is the preferred joint preserving treatment for young adults with symptomatic hip dysplasia and no osteoarthritis. In symptomatic dysplasia of the hip, there is labral pathology in up to 90% of cases. However, no consensus exists as to whether a labral tear should be treated before the periacetabular osteotomy (PAO), treated simultaneously with the PAO, or left alone and only treated if symptoms persist after the PAO. This review is an update of aspects of labral ...[more]

PMID: 23343376

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Project description:PurposeTo determine whether inclusion of the acetabular labrum affects the maximum range of motion (ROM) during simulation of the flexion-adduction-internal rotation impingement examination.MethodsThree-dimensional surface reconstructions of the femur, hemi-pelvis, and labrum from computed tomography arthrography images of 19 participants were used to simulate maximum ROM during the flexion-adduction-internal rotation examination. Simulations were conducted for positions between 70° and 110° flexion and 0° and 20° adduction at 10° increments to measure maximum internal rotation and the position of contact between the femur and acetabular rim (bone-to-bone) or the femur and labrum (bone-to-labrum). Internal rotation angles and clock-face position values were compared between the 2 contact scenarios for each position.ResultsThe ROM in the bone-to-labrum contact model was significantly less than that of the bone-to-bone contact model for all evaluated positions (P ≤ .001, except at 110° flexion and 20° adduction, P = .114). The inclusion of the labrum reduced internal rotation by a median [interquartile range] of 18 [15, 25]° while altering the position of contact on the acetabular clock-face by -0:01 [-0:27, 0:16]. The variability in contact location for the bone-to-labrum contact scenario was nearly double that of the bone-to-bone contact scenario, as indicated by the interquartile range.ConclusionsInclusion of the anatomy of the acetabular labrum in collision models used to simulate impingement examinations reduced the internal rotation ROM by approximately 20° and increased variability in the location of contact relative to the acetabular rim.Clinical relevanceWhile standard bone-to-bone contact ROM simulations may be informative with respect to the relative change in ROM based on a surgical intervention (e.g., pre- and post-osteochondroplasty for cam-type femoroacetabular impingement), they may not accurately represent the clinical ROM of the joint or the kinematic position at which damage may occur due to shape mismatch between the femur and acetabulum.

Dataset Information

The role of the acetabular labrum in hip dysplasia. A literature overview.

Publications

The role of the acetabular labrum in hip dysplasia. A literature overview.

Similar Datasets

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