Acetabular Labral Tears: Result of Arthroscopic Partial Limbectomy

Santori, N.; Villar, Richard N.

doi:10.1016/s0749-8063(00)90121-x

Cited by 207 publications

(111 citation statements)

References 17 publications

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“…The status of the articular cartilage adjacent to a labral tear of the hip is a major determinant of the patient's outcome, and preoperative knowledge of the status of this cartilage is critical for appropriate surgical decision making and for counseling patients regarding their prognosis and recovery [6,10,17,30,31,34,42]. We identified patients who underwent hip arthroscopy for a labral tear and had delamination of the articular cartilage and then correlated the delamination with the presence of a previously undescribed finding on the preoperative plain radiographs, a delamination cyst.…”

Section: Discussionmentioning

confidence: 99%

“…3 of all labral tears seen during hip arthroscopy have associated articular cartilage damage, and it is the extent of this associated injury that is often the limiting determinant on the outcome of arthroscopic labral débridement [5,6,28,30,31,42]. MRI arthrograms are accurate for preoperatively detecting labral lesions, but they have limitations in detecting associated acetabular cartilage delamination [5,7,15,23,43].…”

Section: Discussionmentioning

confidence: 99%

“…Hip arthroscopy is useful in the treatment of labral tears, but labral excision alone does not completely resolve hip pain in patients with concomitant cartilage injury, with success rates of only 21% reported [5,17,35,42]. Microfracture of the acetabulum or acetabular rim resection can be performed in conjunction with the arthroscopy, but in either case the chondral delamination will alter the prognosis and postoperative rehabilitation protocol [6,8,11,28,32,39,40,42]. An open femoroacetabular osteoplasty with resection of as much as 1 cm of the rim of the acetabulum to remove the site of chondral delamination can be planned if preoperatively it is recognized the labral tear is associated with acetabular cartilage delamination [35].…”

Section: Discussionmentioning

confidence: 99%

“…The prognosis of patients with labral tears is multifactorial, but status of the acetabular cartilage remains the most important factor in predicting patient outcome [6,17,34,42]. As a result, treatment of labral tears depends on the severity of the labral injury and whether there is concomitant injury and delamination of the adjacent articular cartilage.…”

Section: Introductionmentioning

confidence: 99%

“…Depending on the status of the acetabular articular cartilage, labral tears secondary to femoroacetabular impingement can be treated by various surgical procedures, including arthroscopic débridement, labral reattachment, labral surgery with concomitant chondral microfracture, or labral surgery with open or arthroscopic femoral head-neck osteochondroplasty [8,10,11,30,31,34,39,40]. The outcomes, complications, and postoperative recovery after these procedures are very different [6,10,16,17,30,31,37,42]. Therefore, preoperative knowledge of the status of the articular cartilage adjacent to the labral tear is critical for appropriate surgical decision making and for counseling patients regarding their prognosis and recovery.…”

Section: Introductionmentioning

confidence: 99%

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Delamination Cysts: A Predictor of Acetabular Cartilage Delamination in Hips with a Labral Tear

Gdalevitch

Smith

Tänzer

2008

Clin Orthop Relat Res

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The treatment and prognosis of labral tears of the hip depend primarily on whether there is concomitant injury of the adjacent acetabular articular cartilage. We asked whether a delamination cyst on the preoperative plain radiographs correlated with delamination of the acetabular articular cartilage at the time of hip arthroscopy. We reviewed the preoperative radiographs of 125 consecutive hips that had a labral tear at hip arthroscopy for the presence of a delamination cyst. A delamination cyst was defined as an acetabular subchondral cyst either directly adjacent to a lateral acetabular cyst or in relation to a subchondral crack in the anterosuperior portion of the acetabulum. All patients with acetabular cartilage delamination at arthroscopy were identified. There were 16 patients with delamination cysts on radiographs and 15 patients with cartilage delamination at arthroscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Delamination Cysts: A Predictor of Acetabular Cartilage Delamination in Hips with a Labral Tear

Gdalevitch

Smith

Tänzer

2008

Clin Orthop Relat Res

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Impairment Tutorial: Rating Tears of the Acetabular Labrum

Brooks¹,

Strain²,

Talmage³

2006

AMA Guides® Newsletter

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The primary function of the acetabular labrum, like that of the glenoid, is to deepen the socket and improve joint stability. Tears of the acetabular labrum are common in older adults but occur in all age groups and with equal frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all rely on production of pain in the groin (typically), clicking, and/or locking with passive or active hip motions. Diagnostic tests or procedures rely on x-rays, conventional arthrography, computerized tomography, magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and hip arthroscopy. Hip arthroscopy is the gold standard for diagnosis but is the most invasive and most likely to result in complications, and MRA is about three times more sensitive and accurate in detecting acetabular labral tears than MRI alone. Surgical treatment for acetabular labrum tears usually consists of arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of-motion tests).

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