Abstract
Objective
Anterior (3 o’clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip.
Material and methods
Seventy-six out of 274 hip MRI records met the inclusion criteria. Two independent blinded investigators evaluated the location of acetabular labral tears (ALTs), edema at the musculotendinous junction of the iliopsoas insertion, femoral neck anteversion angle, femoral neck shaft angle, acetabular anteversion angle, alpha angle, lateral central edge angle (LCEA), acetabular index, and acetabular depth. Comparison analyses between groups were performed.
Results
Twenty-two patients had no ALTs (controls), 19 patients had AALTs, and 35 patients had ALTs not isolated at the 3 o’clock position (25 with cam-bony deformities [FAI-cam] and 10 with pincer-bony deformities [FAI-pincer]). The alpha angle mean was significantly higher (p < 0.001) in the FAI-cam group (62.7º, 95 % confidence interval [CI]: 56.2–69.2º) compared with the AALTs group (46.9º, 95 % CI: 40.1–53.7º). The LCEA mean was significantly higher (p < 0.001) in FAI-pincer group (41.9º, 95 % CI: 39.3º–44.5º) compared to AALTs group (29.4º, 95 % CI: 24.2º–34.6º). There was no statistically significant difference in any of the bony variables between the controls and the AALTs group.
Conclusion
Our study demonstrated that AALTs are pathologically distinct and not associated with FAI or other bony abnormalities. This supports the previous studies, which proposed that AALTs are associated with IPI.
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References
Pfirrmann CW, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J. Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology. 2006;240(3):778–85.
Shindle MK, Voos JE, Nho SJ, Heyworth BE, Kelly BT. Arthroscopic management of labral tears in the hip. J Bone Joint Surg Am. 2008;90 Suppl 4:2–19.
Wenger DE, Kendell KR, Miner MR, Trousdale RT. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res. 2004;426:145–50.
Blankenbaker DG, De Smet AA, Keene JS, Fine JP. Classification and localization of acetabular labral tears. Skeletal Radiol. 2007;36(5):391–7.
Domb BG, Shindle MK, McArthur B, Voos JE, Magennis EM, Kelly BT. Iliopsoas impingement: a newly identified cause of labral pathology in the hip. HSS J. 2011;7(2):145–50.
Blankenbaker DG, Tuite MJ, Keene JS, del Rio AM. Labral injuries due to iliopsoas impingement: can they be diagnosed on MR arthrography? AJR Am J Roentgenol. 2012;199(4):894–900.
Allen WC, Cope R. Coxa saltans: the snapping Hip revisited. J Am Acad Orthop Surg. 1995;3(5):303–8.
Byrd JW. Evaluation and management of the snapping iliopsoas tendon. Instr Course Lect. 2006;55:347–55.
Deslandes M, Guillin R, Cardinal E, Hobden R, Bureau NJ. The snapping iliopsoas tendon: new mechanisms using dynamic sonography. AJR Am J Roentgenol. 2008;190(3):576–81.
Dora C, Houweling M, Koch P, Sierra RJ. Iliopsoas impingement after total hip replacement: the results of non-operative management, tenotomy or acetabular revision. J Bone Joint Surg Br. 2007;89(8):1031–5.
Rezig R, Copercini M, Montet X, Martinoli C, Bianchi S. Ultrasound diagnosis of anterior iliopsoas impingement in total hip replacement. Skeletal Radiol. 2004;33(2):112–6.
Cyteval C, Sarrabere MP, Cottin A, Assi C, Morcos L, Maury P, et al. Iliopsoas impingement on the acetabular component: radiologic and computed tomography findings of a rare hip prosthesis complication in eight cases. J Comput Assist Tomogr. 2003;27(2):183–8.
Toomayan GA, Holman WR, Major NM, Kozlowicz SM, Vail TP. Sensitivity of MR arthrography in the evaluation of acetabular labral tears. AJR Am J Roentgenol. 2006;186(2):449–53.
Sundberg TP, Toomayan GA, Major NM. Evaluation of the acetabular labrum at 3.0-T MR imaging compared with 1.5-T MR arthrography: preliminary experience. Radiology. 2006;238(2):706–11.
Smith T, Hilton G, Toms A, Donell S, Hing C. The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol. 2011;21(4):863–74.
May DA, Disler DG, Jones EA, Balkissoon AA, Manaster BJ. Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. Radiographics. 2000; 20 Spec no:S295–315.
Stelzeneder D, Hingsammer A, Bixby SD, Kim YJ. Can radiographic morphometric parameters for the hip be assessed on MRI? Clin Orthop Relat Res. 2013;471(3):989–99.
Shon WY, Yun HH, Yang JH, Song SY, Park SB, Lee JW. The use of the posterior lesser trochanter line to estimate femoral neck version: an analysis of computed tomography measurements. J Arthroplasty. 2013;28(2):352–8.
Beall DP, Martin HD, Mintz DN, Ly JQ, Costello RF, Braly BA, et al. Anatomic and structural evaluation of the hip: a cross-sectional imaging technique combining anatomic and biomechanical evaluations. Clin Imaging. 2008;32(5):372–81.
Botser IB, Ozoude GC, Martin DE, Siddiqi AJ, Kuppuswami S, Domb BG. Femoral anteversion in the hip: comparison of measurement by computed tomography, magnetic resonance imaging, and physical examination. Arthroscopy. 2012;28(5):619–27.
Muhamad AR, Freitas JM, Bomar JD, Hosalkar H. Acetabular version on magnetic resonance imaging: analysis of two different measuring techniques. Hip Int: J Clin Exp Res Hip Pathol Ther. 2012;22(6):672–6.
Kutty S, Schneider P, Faris P, Kiefer G, Frizzell B, Park R, et al. Reliability and predictability of the centre-edge angle in the assessment of pincer femoroacetabular impingement. Int Orthop. 2012;36(3):505–10.
Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis–what the radiologist should know. AJR Am J Roentgenol. 2007;188(6):1540–52.
Eijer H, Myers SR, Ganz R. Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma. 2001;15(7):475–81.
Rakhra KS, Sheikh AM, Allen D, Beaule PE. Comparison of MRI alpha angle measurement planes in femoroacetabular impingement. Clin Orthop Relat Res. 2009;467(3):660–5.
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Aly, A.R., Rajasekaran, S. & Obaid, H. MRI morphometric hip comparison analysis of anterior acetabular labral tears. Skeletal Radiol 42, 1245–1252 (2013). https://doi.org/10.1007/s00256-013-1652-1
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DOI: https://doi.org/10.1007/s00256-013-1652-1