Document Detail


Radiographic risk factors for labral lesions in femoroacetabular impingement.
MedLine Citation:
PMID:  21748509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tears of the acetabular labrum can lead to pain, disability, and osteoarthritis. Several pathomechanisms have been proposed, including femoroacetabular impingement (FAI). Labral tears have been reported to occur in the presence of even subtle deformities of the acetabulum and femoral head-neck junction.
QUESTIONS/PURPOSES: We analyzed the association of the extent of bony deformity and presence and extent of labral lesions in hips with FAI.
PATIENTS AND METHODS: Radiographs of 123 hips in 116 patients receiving surgical treatment for FAI were analyzed and correlated to the presence and extent of labral lesions. Radiographic parameters of the acetabulum included acetabular index of the weightbearing zone, center-edge angle, inclination of the acetabulum, lateral head extrusion index, and retroversion. On the femoral side, neck-shaft angle, asphericity of the femoral head, superior and anterior alpha angle, offset, and offset ratio were measured. Osteoarthritis was graded according to Tönnis and Kellgren and Lawrence. Labral lesions were graded according to the modified Beck classification. A correlation between labral lesions and age, gender, affected side, type of impingement, and presence and extent of chondromalacia also was tested.
RESULTS: No correlation was found between presence or extent of labral lesions and any radiographic parameter tested, except osteoarthritis classification. The severity of labral lesions correlated to the severity of acetabular chondromalacia as well as patient age (Beck Grade 0 versus Grade 1, Beck Grade 0 versus Grades 1 and 2).
CONCLUSIONS: In the presence of impingement-inducing deformity, the extent of deformation is not associated with the incidence of labral lesions. Labral lesions are associated with early degenerative hip disease in FAI.
LEVEL OF EVIDENCE: Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors:
Thomas Kappe; Tugrul Kocak; Ralf Bieger; Heiko Reichel; Christian R Fraitzl
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Publication Detail:
Type:  Journal Article     Date:  2011-07-12
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-09-30     Completed Date:  2011-11-30     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3241-7     Citation Subset:  AIM; IM    
Affiliation:
Department for Orthopaedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany. thkappe@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Acetabulum / pathology*,  radiography
Adolescent
Adult
Cartilage, Articular / injuries,  pathology*,  radiography
Cross-Sectional Studies
Female
Femoracetabular Impingement / complications,  diagnosis*,  surgery
Femur / pathology*,  radiography
Fractures, Cartilage / complications,  diagnosis*,  surgery
Hip Joint / pathology*,  radiography,  surgery
Humans
Male
Middle Aged
Osteoarthritis, Hip / diagnosis,  etiology,  radiography
Retrospective Studies
Risk Factors
Young Adult
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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