Prospective analysis of hip arthroscopy with 2-year follow-up

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

“…The status of the articular cartilage adjacent to a labral tear of the hip is a major determinant of the patient's outcome, and preoperative knowledge of the status of this cartilage is critical for appropriate surgical decision making and for counseling patients regarding their prognosis and recovery [6,10,17,30,31,34,42]. We identified patients who underwent hip arthroscopy for a labral tear and had delamination of the articular cartilage and then correlated the delamination with the presence of a previously undescribed finding on the preoperative plain radiographs, a delamination cyst.…”

“…From the prospective surgical database, we obtained patient demographics, presence or absence of mechanical symptoms, disease duration, onset of symptoms as classified by Byrd and Jones [4,6] (traumatic from a major trauma such as violent impact or dislocation, acute from a twisting episode, or a well-defined precipitating event or insidious with a gradual onset and worsening symptoms), preoperative radiographic findings, and intraoperative findings. In each case, the preoperative anteroposterior (AP) pelvis and AP, lateral, and frog lateral hip radiographs were reviewed by a blinded independent observer (MG) for the presence of boney abnormalities of the acetabulum and/or femur and arthritic changes [2,16,18,27,46].…”

“…The prognosis of patients with labral tears is multifactorial, but status of the acetabular cartilage remains the most important factor in predicting patient outcome [6,17,34,42]. As a result, treatment of labral tears depends on the severity of the labral injury and whether there is concomitant injury and delamination of the adjacent articular cartilage.…”

“…Depending on the status of the acetabular articular cartilage, labral tears secondary to femoroacetabular impingement can be treated by various surgical procedures, including arthroscopic débridement, labral reattachment, labral surgery with concomitant chondral microfracture, or labral surgery with open or arthroscopic femoral head-neck osteochondroplasty [8,10,11,30,31,34,39,40]. The outcomes, complications, and postoperative recovery after these procedures are very different [6,10,16,17,30,31,37,42]. Therefore, preoperative knowledge of the status of the articular cartilage adjacent to the labral tear is critical for appropriate surgical decision making and for counseling patients regarding their prognosis and recovery.…”

Current concepts in the treatment of adolescent femoroacetabular impingement

“…The potential advantages of arthroscopy over open surgery include lower morbidity, less recovery time, earlier return to full activity and the avoidance of a complete hip dislocation, with less intra-operative blood loss [52,53].…”