Abnormal Structure of the Acetabular Labrum: Prevalence in 1,000 Hip Arthroscopies (SS-58)

ABSTRACTS results of arthroscopic management of labral tears in a consecutive series of patients with 10 year follow-up. Methods: Since 1993 all patients undergoing hip arthroscopy have been prospectively assessed with a modified Harris hip score, preoperatively and postoperatively at 1, 3, 6, 12, 24, 60 and 120 months, or until a subsequent procedure was performed. Variables studied included age, sex, diagnosis, duration of symptoms, onset of symptoms, center edge angle, workers compensation and pending litigation. Fifty-eight procedures were performed on 50 patients who had achieved 10 year followup. Twenty-eight patients (30 hips) were diagnosed with a tear of the acetabular labrum and represent the substance of this study. Management consisted of selective debridement of the damaged labrum with the creation of a stable transition zone, preserving the healthy portion. Results: There was 100% follow-up excluding three deaths (five hips). The most significant confounding variable was the presence of radiographic evidence of arthritis. Among 8 patients with arthritis, 7 (88%) dropped out due to a subsequent total hip arthroplasty. Among 17 patients without arthritis, the median improvement was 36 points (preop 54; postop 90), with 14 (82%) successful outcomes. There were no complications. Conclusions: Arthroscopic labral resection in the absence of radiographic evidence of arthritis can result in successful outcomes with 10 year follow-up. Arthritis is a poor prognostic indicator of long term results.

Abnormal Structure of the Acetabular Labrum: Prevalence in 1,000 Hip Arthroscopies (SS-58). Marc J. Philippon, M.D., Karen K. Briggs, M.P.H., M.B.A., and David A. Kuppersmith, B.S. Summary: The purpose of this study was to describe the arthroscopic appearance and report abnormal structure of the acetabular labrum in 1000 patients who underwent hip arthroscopy. Gender and time from injury to surgery were associated with abnormal labral structure. These abnormalities were also associated with the size of the labrum. Ossified labra were more likely in males and in patients who delayed surgical intervention. More research is needed to determine risk factors for these structural abnormalities which can result in labra that can not be repaired or require reconstruction. Purpose: The use of hip arthroscopy to treat labral tears is increasing. As the diagnosis and treatment algorithm for hip arthroscopy evolves, it is important to determine the prevalence of abnormalities to assist with patient education and expectations. The purpose of this study was to describe the arthroscopic appearance and

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report abnormal structure of the acetabular labrum in 1000 patients who underwent hip arthroscopy. Methods: Detailed surgical information was collected prospectively on 1000 hip arthroscopies between 3/2005 and 8/2007. There were 481 females and 519 males. The average age was 36 years (range 16 to 77). Seven percent of the surgeries were revision arthroscopies. At arthroscopy, details regarding the appearance of the labrum were documented. This included if the labrum was normal, hyperplastic, hypoplastic, or ossified. The color of the labrum was noted as white or yellow. The width of the labrum was measured with an arthroscopic probe of known length with mm graduations. Results: In this study population, 22.6%(226/1000) of the labra were hypoplastic; 7.4% (74/1000) were hyperplastic, and 2.6%(26/1000) were ossified. 10.8 (108/1000) were classified as yellow. Of those that were ossified, 77% had pincer impingement. The average width of the labrum was 6.4 mm (range 1 to 15mm). There was an association between the size of the labrum and abnormal structure(p⫽0.004). The hypoplastic labrum average width was 6.2, the hyperplastic was 9.4, and the ossified labrum was 7.7. The width of the normal labrum was 7.1mm. Women were more likely to have a hypoplastic labrum and men were more likely to have an ossified labrum (p⫽0.001). Males had significantly wider labra(6.7) compared to women(6.1)(p⫽0.002). Patients with hypoplastic labra were significantly younger (35) than patients with hyperplastic labra(45) or ossified labra(42). There was no correlation between age and the width of the labrum. Time from injury was greatest in patients with ossified labra. Conclusions: Gender and time from injury to surgery were associated with abnormal labral structure. These abnormalities were also associated with the size of the labrum. Ossified labra were more likely in males and in patients who delayed surgical intervention. More research is needed to determine risk factors for these structural abnormalities which can result in labra that can not be repaired or require reconstruction. Anterior Labral Tears With Posterior Hip Subluxation or Dislocation (SS-59). Michael K. Shindle, M.D., Bryan T. Kelly, M.D., Clayton G. Lane, M.D., Breehan Kelley, B.A., Russell F. Warren, M.D., and James E. Voos, M.D. Summary: Chronic pain after hip subluxation or dislocation is common, but the etiology is not always clear. Labral pathology associated with this injury is not well described. A retrospective review was performed and we identified that 13 out of 14 patients had MRI or arthro-