Acetabular Labral Tears in Patients with Sports Injury

Abstract

BackgroundWe wanted to investigate acetabular labral tears and their correlation with femoroacetabular impingement in patients with sports injury.MethodsAmong 111 patients who were diagnosed with the acetabular labral tears after arthroscopic treatment from January 2004 to December 2007, we selected 41 patients with sports injury. There were 12 cases of Taekwondo injury, 5 of golf injury, 4 of soccer injury, 3 of gymnastics injury, 2 of Hapkido injury, 2 of aerobics injury, 2 of rock-climbing injury, 2 of fitness training injury and 9 of other sports injuries. We checked the subtypes of acetabular labral tears and the accompanying femoroacetabular impingement. For the cases with accompanying femoroacetabular impingement, we investigated the subtypes according to the types of sports, gender and age. At last follow-up, we checked the Harris Hip Score (HHS), the Hip Outcome Score (HOS) sports scale and the percentage of patients who returned to their sports activity.ResultsThe average age of symptomatic onset was 26 years (range, 12 to 65 years). The ratio of males to females was 29 : 12. An average duration of the hip pain was 17 months (range, 1 to 60 months). The degenerative type of acetabular labral tears was the most prevalent with 32 cases (78%), and there were 9 cases (22%) of the partial tear type. Thirty cases (73%) were accompanied by femoroacetabular impingement. The average age of the 23 cases (56%) of the cam-type was 23 years (range, 12 to 48 years), and it was more likely to occur in men (87%) and for people practicing martial arts such as Taekwondo or Hapkido. An average age of the 5 cases (12%) of the pincer-type was 26 (range, 16 to 43 years), it usually occurred in women (60%) and for non-martial arts such as golf and gymnastics. There were 2 cases of the mixed type (cam + pincer-type). At 27 months follow-up, the HHS was 61 to 92 points, the HOS sports scale increased 43 to 75%, and the rate of returning to sports was 71%.ConclusionsIn spite of the early expression of symptoms and the short duration of the acetabular labral tears, the high rate of degenerative acetabular labral tears in sports patients is likely associated with repetitive injury after the expression of symptoms. Femoroacetabular impingement in sports patients is seemed to be a cause of the early occurrence of acetabular labral tears. Because the possibility of acetabular labral tears is high in femoroacetabular impingement, sports patients may need to undergo early screening for the diagnosis and care of femoroacetabular impingement.

Radiographic Prevalence of Femoroacetabular Impingement in Collegiate Football Players

“…I n younger subjects, hip pain and labral tears occur more frequently in joints with femoroacetabular impingement abnormalities 23,24 . Thus, the high percentage of players with radiographic signs of cam and pincer impingement in the present study suggests that football players may have a high propensity to develop symptomatic femoroacetabular impingement.…”

Anterior Inferior Iliac Spine Morphology Correlates With Hip Range of Motion: A Classification System and Dynamic Model

“…Reduced femoral head-neck offset and asphericity [1,5,6,9] as well as acetabular retroversion [11] are the most widely recognized bony dysmorphisms associated with abnormal contact hip mechanics in young adults with nondysplastic joints. Recent studies, however, indicate that AIIS dysmorphism may also be a potential source of symptomatic hip impingement and that decompression of a prominent AIIS results in improved hip motion and hip function [4,8,10].…”

“…Femoroacetabular impingement is recognized in recent years as a predominant cause of hip pain and labral tears in a young population [1,3,5,6,9,11]. Morphological characteristics most commonly associated with this diagnosis include decreased head-neck offset [1,5,6,9] and retroversion of the acetabulum [11].…”

“…Morphological characteristics most commonly associated with this diagnosis include decreased head-neck offset [1,5,6,9] and retroversion of the acetabulum [11]. Corrective bony procedures in this population are therefore aimed to improve hip kinematics [2] by increasing the head-neck offset and sphericity of the proximal femur and recreating normal version and coverage of the acetabular rim.…”

Atypical Hip Impingement

“…Classic FAI is common in young athletes [50][51][52], but there have been several reports about atypical impingement associated with extreme hip motion in ballet dancing, martial arts, and other sports [9,[53][54][55]. In such patients, a "pincerlike" impingement is caused by excessive hip motion, without the presence of the acetabular pathomorphology that is seen in the classic pincer type of impingement [56].…”