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Review
. 2019 Jan 20;132(2):211-219.
doi: 10.1097/CM9.0000000000000020.

Diagnosis and treatment of labral tear

Tiao Su  1 , Guang-Xing Chen, Liu Yang
Affiliations
Review

Diagnosis and treatment of labral tear

Tiao Su et al. Chin Med J (Engl). .

Abstract

Objective: To review the literature regarding diagnosis and treatment of labral tear.

Data sources: A systematic search was performed in PubMed using various search terms and their combinations including hip, labrum, acetabular labral tear, arthroscopy, diagnosis, and anatomy.

Study selection: For each included study, information regarding anatomy, function, etiology, diagnosis, and management of acetabular labral tear was extracted.

Results: Five hundred and sixty abstracts about anatomy, function, etiology, diagnosis, and management of acetabular labral tear were reviewed and 66 selected for full-text review. The mechanism of labral tear has been well explained while the long-term outcomes of various treatment remains unknown.

Conclusions: Labral tear is generally secondary to femoroacetabular impingement, trauma, dysplasia, capsular laxity, and degeneration. Patients with labral tear complain about anterior hip or groin pain most commonly with a most consistent physical examination called positive anterior hip impingement test. Magnetic resonance arthrography is a reliable radiographic examination with arthroscopy being the gold standard. Conservative treatment consists of rest, non-steroidal anti-inflammatory medication, pain medications, modification of activities, physical therapy, and intra-articular injection. When fail to respond to conservative treatment, surgical treatment including labral debridement, labral repair, and labral reconstruction is often indicated.

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Figures

Figure 1
Figure 1
Relationship of the acetabular labrum and capsule. A: Articular cartilage; B: Acetabulum; C: Capsule; L: Labrum; TM: Tide mark.
Figure 2
Figure 2
(A) Bony over-coverage of the anterior labrum. (B) With hip flexion, the anterior labrum gets crushed by the pincer lesion against the neck of the femur. (C) Bony prominence centered on the anterolateral femoral head/neck junction. (D) Delamination of labrum and cartilage progresses as the cam lesion glides under the labrum with hip flexion.
Figure 3
Figure 3
(A) Demonstrates a lateral center-edge angle of the right hip of 16° and acetabular roof angle or Tönnis angle of 27°. These measurements are both considered abnormal and consistent with acetabular dysplasia. (B) Coronal section magnetic resonance imaging of a dysplastic hip. The labrum is hypertrophic and contrast medium is running through the base of the labrum, an indication that the labrum is detached from the acetabular rim.
Figure 4
Figure 4
The impingement test is performed by provoking pain with flexion, adduction, and internal rotation of the symptomatic hip.
Figure 5
Figure 5
(A) AP view of the right hip. The anterior (white dots) and posterior (black dots) rim of the acetabulum are marked. The superior portion of the anterior rim lies lateral to the posterior rim indicating overcoverage of the acetabulum. Anteriorly, it assumes a more normal medial position, creating the crossover sign as a positive indicator of pincer impingement. (B) Fat-suppressed oblique axial proton density weighted image shows linear high signal separating the anterior labrum roughly in halves, a radial tear.
Figure 6
Figure 6
Arthroscopic view of a left hip from the anteriorolateral portal. (A) A fragmented labral tear with degeneration within its substance is identified. (B) The damaged portion has been removed, preserving the healthy substance of the labrum.
Figure 7
Figure 7
An anterior labral repair is performed in this left hip. (A) The tear is probed from the anteriorolateral portal. (B) One anchors have been placed with all two suture limbs passed through the labrum in a mattress pattern.
Figure 8
Figure 8
(A) Preoperative MRI reveals a labral tear with formation of paralabral cyst. (B) Intraoperative photograph after complete labral reconstruction with iliotibial band autograft. (C) AP pelvis radiograph after surgery with no evidence of radiograph arthrosis.
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References

    1. Dameron TB., Jr Bucket-handle tear of acetabular labrum accompanying posterior dislocation of the hip. J Bone Joint Surg Am 1959;41-A:131–134. - PubMed
    1. Suzuki S, Awaya G, Okada Y, Maekawa M, Ikeda T, Tada H. Arthroscopic diagnosis of ruptured acetabular labrum. Acta Orthop Scand 1986;57:513–515. - PubMed
    1. Robertson WJ, Kadrmas WR, Kelly BT. Arthroscopic management of labral tears in the hip: a systematic review of the literature. Clin Orthop Relat Res 2007;455:88–92. doi: 10.1097/BLO.0b013e31802c7e0f. - PubMed
    1. Wenger D, Kendell K, Miner M, Trousdale RT. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res 2004;426:145–150. - PubMed
    1. Tanzer M, Noiseux N. Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthop Relat Res 2004;429:170–177. - PubMed