Delamination Cysts: A Predictor of Acetabular Cartilage Delamination in Hips with a Labral Tear

Abstract

The treatment and prognosis of labral tears of the hip depend primarily on whether there is concomitant injury of the adjacent acetabular articular cartilage. We asked whether a delamination cyst on the preoperative plain radiographs correlated with delamination of the acetabular articular cartilage at the time of hip arthroscopy. We reviewed the preoperative radiographs of 125 consecutive hips that had a labral tear at hip arthroscopy for the presence of a delamination cyst. A delamination cyst was defined as an acetabular subchondral cyst either directly adjacent to a lateral acetabular cyst or in relation to a subchondral crack in the anterosuperior portion of the acetabulum. All patients with acetabular cartilage delamination at arthroscopy were identified. There were 16 patients with delamination cysts on radiographs and 15 patients with cartilage delamination at arthroscopy.

Open Treatment of Femoroacetabular Impingement is Associated with Clinical Improvement and Low Complication Rate at Short-term Followup

“…There was relatively even distribution of preoperative Tönnis radiographic grade for OA for Grades 0 through 2 (Table 1). No acetabular delamination cysts were observed in retrospective review of preoperative radiographs [17], which may be related to patient selection for THA versus SDO in our series.…”

Examination of acetabular labral tear: a continued diagnostic challenge

“…Pincer FAI morphology has a higher prevalence in middle-aged women 63. Abnormal coverage of the acetabulum of the proximal femur predisposes to abnormal contact.…”

“…A subchondral cyst in the acetabulum and/or femoral head usually denotes overlying high-grade chondral loss and is thus important to note 63 70. Additionally, while joint space width is affected by many factors, including pelvis orientation and radiographic beam angulation, a joint space width of 2 mm or less, a surrogate for advanced chondral loss, has a high association with the eventual need for THA 71…”

Hip-Preserving Surgery: Understanding Complex Pathomorphology

“…The most notable primary radiographic findings in patients with cam-type femoroacetabular impingement are reduced femoral head-neck offset, an alpha angle of >50°and an aspherical femoral head 26,29,36,37 . Secondary findings include herniation pit or cyst formation at the head-neck junction, increased cortical density, and acetabular cyst formation [38][39][40][41] . The underlying treatment principle is restoration of the normal femoral head-neck offset and, where possible, treatment of the resulting chondrolabral damage.…”