Biomechanics, anatomy, pathology, imaging and clinical evaluation of the acetabular labrum: current concepts

Hartigan, David E.; Perets, Itay; Meghpara, Mitchell B.; Mohr, Mitchell R.; Close, Mary R.; Yuen, Leslie C.; Domb, Benjamin G.

doi:10.1136/jisakos-2017-000159

Cited by 8 publications

(9 citation statements)

References 46 publications

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“…The decrease in dynamic balance ability of symptomatic and asymptomatic patients may be due to the possibility of microlabral injury. The acetabular labrum is rich in nerve end organs that play an important role in proprioceptive feedback related to dynamic balance [ 34 ]. Therefore, the labrum potentially modulates hip proprioception and damage to the labrum may lead to impaired proprioceptive feedback.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Biomechanical and Physical Function According to Symptomatic and Asymptomatic Acetabular Impingement Syndrome in Young Adults

et al. 2022

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Femoroacetabular impingement (FAI) is caused by hip joint anomalies. Although asymptomatic and symptomatic FAI have been reported in young adults, information on biomechanical and functional characteristics of FAI is rare. We compared the subjective hip score, range of motion (ROM), dynamic balance, and hip strength between symptomatic FAI (FAIsym) and asymptomatic FAI (FAIasym) groups and healthy controls. Participants (n = 307; men: 155, women: 152) were classified according to morphological abnormalities and hip joint symptoms, comprising symptomatic FAI, asymptomatic FAI, and healthy controls. The Copenhagen Hip and Groin Outcome Score (HAGOS), hip ROM, Y-balance test (YBT), and isokinetic hip strength were measured. The types of FAI were not significantly differenent in both men and women. FAIsym exhibited significantly reduced HAGOS, whereas FAIasym showed no significant difference compared to the healthy group (men: healthy 91.7 vs. FAIasym 87.2 vs. FAIsym 49.9, women: healthy 91.7 vs. FAIasym 86.2 vs. FAIsym 53.9). Hip flexion, adduction, and internal and external rotation ROMs were only significantly reduced in symptomatic FAI. Asymptomatic and symptomatic FAI groups displayed significantly lower YBT scores than healthy controls (men healthy: 84.9 vs. FAIasym: 69.0 vs. FAIsym 58.7, women healthy 79.2 vs. FAIasym 64.0 vs. FAIsym 55.5). Isokinetic hip flexion, adduction, and abduction strengths were significantly lower in FAIsym. In conclusion, FAIasym showed no decrease in muscle strength but displayed reduced dynamic balance. Subjective satisfaction, ROM, muscle strength, and dynamic balance were lower in FAIsym compared to FAIasym and healthy groups.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Biomechanical and Physical Function According to Symptomatic and Asymptomatic Acetabular Impingement Syndrome in Young Adults

et al. 2022

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“…Femoroacetabular impingement (FAI) was evaluated using anterior, lateral, and posterior impingement tests. 19 A positive test suggestive of labral pathology was considered when deep anterior groin pain was reported using these maneuvers. Abductor strength was measured with the patient lying on the contralateral side with the affected leg abducted, extended at the hip and knee, and slightly internally rotated.…”

Section: Methodsmentioning

confidence: 99%

Return to Activity After Gluteus Medius Repair in Active Patients Older Than 50 Years

Meghpara

Yelton

Annin

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Gluteus medius (GM) tears are a known cause of dysfunction and disability predominantly in older women. Purpose To report on return to activity, patient-reported outcomes (PROs), and a uniquely calculated minimal clinically important difference (MCID) at a minimum 2-year follow-up for active patients who had undergone either an endoscopic or an open GM repair. Study Design: Case series; Level of evidence, 4. Methods: Patients were considered eligible if they (1) underwent a GM repair with or without concomitant central and peripheral compartment procedures; (2) had baseline preoperative and minimum 2-year scores for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain; and (3) participated in a physical activity or sport within 1 year before their surgery. Return to activity was defined as the patient being able to participate in his or her activity at a minimum of 2 years postoperatively. Results: Of 87 eligible patients, 84 (96.6%) met all inclusion criteria. The mean follow-up was at 44.5 months. Six patients (7.1%) underwent an open GM repair, while the remaining 78 (92.9%) underwent an endoscopic GM repair. Concomitant central and peripheral compartment arthroscopic procedures were performed in 69 patients (82.1%). All PROs significantly ( P < .001) improved as follows: mHHS, from 59.0 to 85.8; NAHS, from 57.9 to 84.0; HOS-SSS, from 32.6 to 63.7; and VAS pain, from 5.4 to 1.9. A total of 57 patients (67.9%) returned to their preoperative activity at the 2-year follow-up. The MCID was calculated for the mHHS, NAHS, and HOS-SSS to be 7.5, 7.4, and 10.9, respectively, with 79.3%, 86.4%, and 70.2% of patients achieving the MCID for each respective PROs. Conclusion: Active patients over the age of 50 years may benefit from endoscopic or open repair of GM tears, as the majority of patients in our cohort were able to return to their activity of choice. All measured PROs had significantly improved at a minimum 2-year follow-up, with high survivorship, satisfaction, and clinical effectiveness. Patients with partial-thickness tears compared with full-thickness tears and those who underwent isolated GM repair compared with GM repair with concomitant procedures had similar return to activity rates and PROs at the latest follow-up.

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“…Femoroacetabular impingement (FAI) was assessed with anterior, lateral, and posterior impingement tests. 15 Labral pathology requiring treatment was indicated when patients conveyed deep anterior groin pain with these tests. GM pathology was assessed as greater trochanteric tenderness, abductor weakness, and a positive Trendelenburg sign.…”

Section: Methodsmentioning

confidence: 99%

Differences in Clinical Presentations and Surgical Outcomes of Gluteus Medius Tears Between Men and Women

et al. 2020

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Background: Gluteus medius (GM) tears often occur in women aged >50 years. There is a paucity of literature comparing sex-based differences in those undergoing GM repair. Purpose: To report differences between women and men in clinical presentations and patient-reported outcome (PRO) scores at a minimum 2-year follow-up after undergoing GM repair. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed. All included patients had postoperative scores for the following PROs: modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), and International Hip Outcome Tool–12. Men were propensity score matched 1:3 to women according to concomitant arthroscopic procedures and follow-up time. Clinical effectiveness was determined through a uniquely calculated minimal clinically important difference (MCID) for the mHHS and NAHS specific to this study population. Results: Thirteen men were successfully propensity score matched to 39 women. Women and men were 55.87 ± 11.0 and 62.38 ± 11.63 years old (mean ± SD), respectively ( P = .02). Men were at increased risk for associated lumbar pathology as compared with women (relative risk, 3.32; P = .02). Women showed significant improvement from preoperative to minimum 2-year follow-up for the mHHS (59.32 ± 15.36 to 83.81 ± 16.82; P < .01), NAHS (56.23 ± 15.61 to 83.78 ± 17.66; P < .01), HOS-SSS (33.35 ± 20.28 to 67.88 ± 32.35; P < .01), and visual analog scale (5.48 ± 2.00 to 1.93 ± 2.29; P < .01). Similarly, men showed significant improvement for the mHHS (63.50 ± 16.41 to 84.77 ± 13.91; P < .01), NAHS (61.52 ± 9.87 to 84.42 ± 14.87; P < .01), HOS-SSS (33.97 ± 21.20 to 63.62 ± 26.20; P < .01), and visual analog scale (4.93 ± 2.69 to 1.86 ± 2.10; P < .01). The MCIDs for the mHHS and NAHS were calculated to be 7.89 and 7.24. Of the women, 28 (72%) and 34 (87%) met the MCID for the mHHS and NAHS. Eleven (85%) men met the MCID for the mHHS and NAHS. Conclusion: These results suggest that women and men can both benefit after GM repair. Men were older and had increased risk for associated lumbar pathology than women at the time of surgery. Men and women both experienced significant improvements in PROs and compared favorably in terms of clinical effectiveness at a minimum 2-year follow-up.

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Biomechanics, anatomy, pathology, imaging and clinical evaluation of the acetabular labrum: current concepts

Cited by 8 publications

References 46 publications

Characteristics of Biomechanical and Physical Function According to Symptomatic and Asymptomatic Acetabular Impingement Syndrome in Young Adults

Characteristics of Biomechanical and Physical Function According to Symptomatic and Asymptomatic Acetabular Impingement Syndrome in Young Adults

Return to Activity After Gluteus Medius Repair in Active Patients Older Than 50 Years

Differences in Clinical Presentations and Surgical Outcomes of Gluteus Medius Tears Between Men and Women

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