2021 ISAKOS Biennial Congress ePoster
Labral Size Correlates With Increasing Intraarticular Damage At Time Of Arthroscopy In Borderline Dysplastic Patients
Jacob Shapira, MD, Des Plaines UNITED STATES
Jeffrey Chen, BA, Des Plaines, Illinois UNITED STATES
Mitchell Yelton, BS, Des Plaines, Illinois UNITED STATES
Philip Joseph Rosinsky, MD, Skokie, IL UNITED STATES
David R. Maldonado, MD, Houston, TX UNITED STATES
Mitchell Meghpara, MD, Austin, TX UNITED STATES
Ajay C. Lall, MD, MS, FAAOS, Paramus, New Jersey UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES
American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES
FDA Status Cleared
Summary
An inverse relationship may exist between acetabular depth and labral size.
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Abstract
Background
Although a previous association between the severity of the acetabular dysplasia and labral size has been established, it is still not clear whether large labra play a protective role in borderline dysplastic hips in terms of intraarticular damage.
Objectives
The aims of this study were: (1) to confirm the relationship between osseous coverage and labral size, and (2) to investigate the severity of intraarticular damage in borderline dysplastic hips in correlation to labral size.
Study Design & Methods
Patients treated with primary hip arthroscopy for symptomatic labral tears between 2010 and 2018 were considered for this study. Patients were included if they had preoperative radiographic measures and intraoperative assessments of the labra and cartilage. The study group was divided into borderline dysplastic and non-dysplastic groups via three measurements: lateral center edge angle (LCEA), acetabular index (Ax), and anterior center edge angle (ACEA). Undercoverage was defined as LCEA = 25°, Ax =10°, and ACEA = 20°. The labrum was measured in four quadrants: anterosuperior (AS), anteroinferior (AI), posterosuperior (PS), and posteroinferior (PI). Additionally, to assess cartilage damage in borderline dysplastic hips, hips with average labral size in the top quartile were compared to
hips with average labral size in the bottom quartile.
Results
A total of 1765 hips (1589 patients) were included in the study. The mean LCEA, Ax, and ACEA between the borderline dysplastic and non-dysplastic groups were significantly different (P <0.001). According to the Ax classification, there was significant evidence that borderline dysplastic hips had larger labra (P < 0.05). Among the dysplastic group, there was significantly more cartilage damage according to the Outerbridge classifications along both the acetabulum and femoral head in hips with labra in the upper quartile.
Conclusions
An inverse relationship may exist between acetabular depth and labral size. Additionally, specifically in borderline dysplastic hips, a relatively large labrum correlates with worse intra-articular damage compared to borderline dysplastic hips with a relatively small labrum. Larger labral size may indicate a higher degree of instability in patients with borderline dysplasia.