Marc J Philippon1, Karen K Briggs, Teddy Fagrelius, Dianna Patterson. 1. Steadman Philippon Research Institute, 181 W. Meadow Dr., Suite 1000, Vail, CO 81657 USA ; The Steadman Clinic, Vail, CO USA ; Department of Surgery, McMasters University, Hamilton, Ontario Canada.
Abstract
BACKGROUND: Labral tears have been associated with femoroacetabular impingement, instability, sports-related activity or trauma, capsular laxity or hypermobility, dysplasia, and degeneration. Disruption of the labrum increases the rate of acetabular cartilage compression and the contact stress between the femoral and acetabular cartilage. If left untreated, these lesions will alter normal hip joint function and may eventually lead to osteoarthritis. METHODS: For the labrum with adequate tissue (>7 mm), the labrum is repaired if it is detached or torn. If the labrum is bruised, a rim reduction and repair is performed, especially in the presence of cartilage damage and the labral-chondral junction. Labri are debrided only if there is enough substance to maintain the function of the labrum. Care must be taken to fix the labrum so that it provides adequate seal with the femoral head. RESULTS: Two-year outcome on 122 patients who underwent arthroscopic treatment for femoroacetabular impingement and chondrolabral dysfunction showed that, overall, most patients showed an improvement in symptoms and function and were satisfied with the results. Independent predictors of improved outcomes were joint space >2 mm and repair of labral pathology instead of debridement. Several other studies have shown excellent results following labral refixation and repair. CONCLUSIONS: Labral tears have been associated with femoroacetabular impingement, instability, sports-related activity or trauma, capsular laxity or hypermobility, dysplasia, and degeneration. Untreated labral tears can result in premature osteoarthritis of the hip. Debridement only used to be the standard of care, but excellent results reveal arthroscopic labral repair and refixation are an option with good outcomes.
BACKGROUND: Labral tears have been associated with femoroacetabular impingement, instability, sports-related activity or trauma, capsular laxity or hypermobility, dysplasia, and degeneration. Disruption of the labrum increases the rate of acetabular cartilage compression and the contact stress between the femoral and acetabular cartilage. If left untreated, these lesions will alter normal hip joint function and may eventually lead to osteoarthritis. METHODS: For the labrum with adequate tissue (>7 mm), the labrum is repaired if it is detached or torn. If the labrum is bruised, a rim reduction and repair is performed, especially in the presence of cartilage damage and the labral-chondral junction. Labri are debrided only if there is enough substance to maintain the function of the labrum. Care must be taken to fix the labrum so that it provides adequate seal with the femoral head. RESULTS: Two-year outcome on 122 patients who underwent arthroscopic treatment for femoroacetabular impingement and chondrolabral dysfunction showed that, overall, most patients showed an improvement in symptoms and function and were satisfied with the results. Independent predictors of improved outcomes were joint space >2 mm and repair of labral pathology instead of debridement. Several other studies have shown excellent results following labral refixation and repair. CONCLUSIONS: Labral tears have been associated with femoroacetabular impingement, instability, sports-related activity or trauma, capsular laxity or hypermobility, dysplasia, and degeneration. Untreated labral tears can result in premature osteoarthritis of the hip. Debridement only used to be the standard of care, but excellent results reveal arthroscopic labral repair and refixation are an option with good outcomes.
Authors: Matthew J Crawford; Christopher J Dy; Jerry W Alexander; Matthew Thompson; Steven J Schroder; Charles E Vega; Rikin V Patel; Andrew R Miller; Joseph C McCarthy; Walter R Lowe; Philip C Noble Journal: Clin Orthop Relat Res Date: 2007-12 Impact factor: 4.176
Authors: R Stephen J Burnett; Gregory J Della Rocca; Heidi Prather; Madelyn Curry; William J Maloney; John C Clohisy Journal: J Bone Joint Surg Am Date: 2006-07 Impact factor: 5.284
Authors: Casey A Myers; Bradley C Register; Pisit Lertwanich; Leandro Ejnisman; W Wes Pennington; J Erik Giphart; Robert F LaPrade; Marc J Philippon Journal: Am J Sports Med Date: 2011-07 Impact factor: 6.202
Authors: Jonathan D Haskel; Daniel J Kaplan; Noah Kirschner; Jordan W Fried; Mohammad Samim; Christopher Burke; Thomas Youm Journal: Arthrosc Sports Med Rehabil Date: 2021-03-15