Clinical diagnosis and arthroscopic treatment of acetabular labral tears

To investigate the clinical diagnosis and arthroscopic treatment of acetabular labral tears.

Twenty-one patients with unilateral acetabular labral tears hospitalized from November 2008 to December 2009 were included in this retrospective study. A definitive diagnosis was made preoperatively on the basis of physical examination, plain radiography and magnetic resonance arthrography (MRA). All cases were treated with arthroscopic surgeries: labral debridement (14 cases), labral debridement plus femoral osteoplasty (5 cases), and labral repair plus osteoplasty (2 cases). All patients were followed-up and the results evaluated using the visual analogue scale (VAS) and Harris hip score.

A positive flexion, abduction and internal rotation (FADIR) impingement sign was found in all 21 affected hips, a positive flexion, abduction and external rotation (FABER) impingement sign in 15, and a positive McCarthy test in 9. Plain radiography showed 11 cases had cam type impingement, in 6 of whom it was combined with pincer type impingement; and 2 cases had acetabular retroversion alone. Labral tears were observed on MRA in all cases and were all confirmed by arthroscopy. All patients were followed up for an average of 11.6 months (range, 6 to 19 months). The VAS decreased from (5.3 ± 1.3) preoperatively to (1.4 ± 0.9) 6 months postoperatively. The mean Harris hip score improved from (63 ± 9) preoperatively to (84 ± 10) 6 months postoperatively. All these differences were statistically significant.

Acetabular labral injury is closely correlated with femoro-acetabular impingement. Impingement tests and MRA have high sensitivity and accuracy in clinical diagnosis of labral tears. Arthroscopic debridement, repair and osteoplasty for labral tears results in a good early outcome.