Does the Nature of Chondrolabral Injury Affect the Results of Open Surgery for Femoroacetabular Impingement?

Abstract

Background The degree to which patient characteristics, clinical outcomes, and the nature, severity, and corresponding treatment of chondrolabral injury in femoroacetabular impingement (FAI) is associated with failure after surgery is incompletely understood. Conclusions We were unable to identify an increased risk of poor outcomes based on sex, body mass index, or severity of chondrolabral lesions. We did find an increased risk of poorer outcomes associated with age. Labral refixation was associated with a decrease in the risk of failure indicating that treatment methodology, rather than the nature of the chondrolabral injury, may be associated with clinical failure. Future studies will be needed to help determine optimal treatment strategies for chondrolabral injuries. Level of Evidence Level IV, therapeutic study.

Treatment of cam-type femoroacetabular impingement using anterolateral mini-open and arthroscopic osteochondroplasty

“…Boone et al supposed that caution should be taken to perform surgical dislocation in patients over the age of 40 [30]; in our series using minimally invasive approach, patients younger than 55 still gained benefit from the surgery. It still remained controversial if labral tears itself and the types of management to a torn labrum would influence the surgical outcomes [1, 38]. Laude et al observed no difference in clinical results between patients with labral refixation and those without [18].…”

“…Femoroacetabular impingement (FAI) is one of the most common causes of groin pain in young adults [1]. The prevalence ranges around 10% to 15% in young active patients and up to 94% of young patients with hip pain [2].…”

Elephant’s ear sign: a new radiographic finding indicative of acetabular retroversion

“…Diagnosis of acetabular retroversion is usually made on plain radiographs that may demonstrate COS [1], PWS [1], and PRIS sign [8]. Most patients with acetabular retroversion present with a labral tear and signs of FAI [10][11][12][13]. Thus, diagnosis of acetabular retroversion may be missed in some patients unless the radiographs are carefully scrutinized.…”

“…Distinction between acetabular retroversion resulting in labral tear or other symptoms and labral tear resulting from classical FAI without DDH is important as the treatment modality for these patients differs. Patients with severe acetabular retroversion may require reorientation osteotomy of the pelvis that has been demonstrated to have excellent outcome in properly selected patient populations [10,11]. Isolated labral repair in patients with moderate to severe DDH is likely to fail and result in accelerated arthritis of the hip [12,13].…”

“…Isolated labral repair in patients with moderate to severe DDH is likely to fail and result in accelerated arthritis of the hip [12,13]. Patients with acetabular retroversion and positive PWS are best treated with reorientation osteotomy such as reverse periacetabular osteotomy [11][12][13]. Thus, identification of patients with acetabular retroversion is of paramount importance in allowing implementation of the most appropriate treatment.…”