Labral Injury: Radiographic Predictors at the Time of Hip Arthroscopy

• Published in: Arthroscopy Vol. 31; no. 1; pp. 51 - 56
• Main Authors: Redmond, John M., M.D, Gupta, Asheesh, M.D, Hammarstedt, Jon E., B.S, Stake, Christine E., M.A, Dunne, Kevin F., B.S, Domb, Benjamin G., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2015
• Subjects: Adult; Age Factors; Arthroscopy; Cartilage, Articular - diagnostic imaging; Cartilage, Articular - injuries; Debridement; Female; Femur Neck - diagnostic imaging; Hip Injuries - diagnostic imaging; Hip Joint - diagnostic imaging; Humans; Linear Models; Male; Middle Aged; Orthopedics; Prospective Studies; Radiography; Regression Analysis; Risk Factors; Rupture - diagnostic imaging; Rupture - surgery; Sex Factors
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2014.07.002

Purpose The purpose of this study was to investigate the influence of multiple demographic and radiographic findings on the size of labral tears identified at the time of hip arthroscopy. Methods Data were prospectively collected for patients treated with arthroscopic labral repair or debridement from February 2008 to August 2011. Preoperative radiographic and demographic data were collected for 392 patients during the study period. Exclusion criteria included revision surgery and previous hip conditions. An anteroposterior pelvic view, 45° Dunn view, and false-profile view were used to measure Tönnis grade, neck-shaft angle, alpha angle, lateral center edge angle (LCEA), anterior center edge angle (ACEA), acetabular inclination, and the extent of crossover sign when present. At the time of surgery, labral tear size and location were documented for all patients, using traditional acetabular clock face nomenclature for sizing. A multiple linear regression analysis was then performed to assess the correlation of radiographic and demographic findings with the size of the labral tear. Results Regression analysis displayed statistical significance for sex ( P < .0001), age ( P < .0001), and alpha angle ( P  = .005) with labral tear size. For female patients, Tönnis grade ( P  = .0004) and neck-shaft angle ( P  = .004) correlated with labral tear size. This model accounted for only 26% of variation in labral tear size. Conclusions Preoperative risk factors for the extent of labral tear size are male sex, increasing age, and increasing alpha angle. Labral tears were larger in female patients with higher Tönnis grades and lower neck-shaft angles. Measurements of acetabular coverage and version showed no correlation with labral tear size. The majority of labral tear size variation was not accounted for in this model. Level of Evidence Level IV, therapeutic case series.