Inverted Acetabular Labrum

Zhang, Huiliang; Liang, Junsheng; Li, Ligeng; Luo, Dan; Xiao, Kai; Cheng, Hui; Zhao, Hong

doi:10.4103/0366-6999.196582

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…T he acetabular labrum is a fibrocartilaginous soft tissue structure which lines the superior rim of the acetabulum and is an important component of normal hip biomechanics. [1][2][3] The labrum increases the contact area between the femoral head and acetabulum; this decreases load stress and preserves the articular cartilage from degenerative changes. 1,3,4 The labrum also forms a seal between the acetabulum and the femoral head to resist distraction forces and hold the synovial fluid within the joint space.…”

mentioning

confidence: 99%

“…4 Multiple hip pathologies, including earlyonset osteoarthritis and avascular necrosis (AVN) in the setting of hip dysplasia, have been associated with the presence of an inverted acetabular labrum. 2,5,6 Developmental dysplasia of the hip (DDH) is a disorder encompassing a spectrum of abnormal hip development that can lead to subluxation, dislocation, and degenerative arthritis. In children aged below 6 months, DDH is often treated using the Pavlik harness; the Pavlik harness maintains the femur in flexion and abduction to center the femoral head within the acetabulum and promote proper development of the hip while avoiding complete immobilization of the joint.…”

mentioning

confidence: 99%

“…The labrum also forms a seal between the acetabulum and the femoral head to resist distraction forces and hold the synovial fluid within the joint space 4. Multiple hip pathologies, including early-onset osteoarthritis and avascular necrosis (AVN) in the setting of hip dysplasia, have been associated with the presence of an inverted acetabular labrum 2,5,6…”

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confidence: 99%

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An Inverted Acetabular Labrum Is Predictive of Pavlik Harness Treatment Failure in Children With Developmental Hip Dysplasia

Lin

Siddiqui

Lai

et al. 2021

Journal of Pediatric Orthopaedics

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Introduction:The failure rate of Pavlik harness treatment for developmental dysplasia of the hip (DDH) has been reported as high as 55%. The purpose of this study is to investigate the effect of an inverted acetabular labrum on outcomes of Pavlik harness treatment for DDH. Methods: A retrospective review was conducted on DDH patients at a tertiary care pediatric hospital from 2004 to 2016. DDH patients that underwent index treatment with Pavlik harness and had minimum 12 months follow-up were included. Medical charts were reviewed for demographics, treatment, and outcomes. Outcomes were compared between patients with an inverted labrum versus those without an inverted labrum. Results: A total of 156 patients with 229 dysplastic hips were included. The mean age at initiation of Pavlik harness treatment was 1.9 ± 1.4 months and mean follow-up was 37.7 ± 23.0 months. Bilateral DDH was diagnosed in 46% (73/156) of patients. In all, 37% (75/229) of hips failed Pavlik harness index treatment. Second-line treatment was rigid hip abduction bracing in 91% (68/75) of hips, closed reduction in 5% (4/75) of hips, and open reduction in 4% (3/75) of hips. An inverted labrum was present in 10% (22/229) of all hips. The incidence of Pavlik harness treatment failure was 91% (20/22) in the inverted labrum group compared with 27% (55/207) in the control group (P < 0.001). Closed or open reduction was required in 86% (15/22) of the inverted labrum group compared with 3% (7/207) of hips in the control group (P < 0.001). The incidence of avascular necrosis was 18% (4/22) in hips with an inverted labrum compared with 0.4% (1/207) in the control group (P < 0.001). Conclusions: In children with DDH undergoing index treatment in a Pavlik harness, the presence of an inverted acetabular labrum is strongly predictive of treatment failure. Dysplastic hips with an inverted labrum also have a significantly higher risk of requiring closed or open reduction and developing avascular necrosis compared with those without an inverted labrum. Level of Evidence: Level III.

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An Inverted Acetabular Labrum Is Predictive of Pavlik Harness Treatment Failure in Children With Developmental Hip Dysplasia

Lin

Siddiqui

Lai

et al. 2021

Journal of Pediatric Orthopaedics

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“…[ 1 ] As 90% of children with symptomatic DDH have lesions on the acetabular labrum, we initiated a magnetic resonance imaging (MRI) study of acetabular labrums of dysplastic hips to determine how magnetic resonance-based parameters and contents of joint space could be used to evaluate the therapeutic effect of closed reduction in DDH patients. [ 2 ]…”

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confidence: 99%