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Anatomy, Surgical Management, and Postoperative Outcomes of Acetabular Labral Tears

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Lower Extremity Joint Preservation

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Abstract

The labrum (the cotyloid ligament) is a key anatomical structure in the hip joint. It is a triangular fibrocartilaginous structure that forms a horseshoe-shaped attachment to the acetabular rim maintaining fluid pressurization and the hip seal, stabilizing the joint to distraction forces, and controlling contact pressure. Labral tears are common cause of hip pain and dysfunction. The labrum can be damaged as a result of a number of pathologies, such as femoroacetabular impingement (FAI), dysplasia, capsular laxity, and trauma (acute and chronic). There are two subtypes of FAI: CAM (femoral head-neck junction deformity) and pincer (focal or global overcoverage of the acetabulum). Clinical studies show that alterations in labral morphology, such as tears, can contribute to changes in the joint which are consistent with early osteoarthritis. Reattachment, or reconstruction of the labrum, may improve the biomechanics of the hip, thereby slowing the progression of arthritis.

The indications for surgical treatment include the presence of symptoms for more than 6 months, radiographic confirmation of FAI abnormalities, and failure of conservative treatment. The main contraindication is arthritis in the form of cartilage damage as well as joint space measurement of less than 2 mm.

In general hip arthroscopy results in an improvement of function in more than 88% of patients.

More than 93% of the patients returned professional sport. It is worth noting that around 78% maintain this level of activity at a mean of 1.5 years after follow-up.

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  1. Department of the Orthopedic Surgery and Sports Medicine, Carolina Medical Center, Warsaw, Poland

    Lukasz Luboinski, Maciej Pasieczny, Patryk Ulicki & Tomasz Albrewczyński

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  1. Kungsbacka Hospital, RHO, University of Gothenburg Kungsbacka Hospital, RHO, Kungsbacka, Sweden

    Mats Brittberg

  2. Słynarski Knee Clinic, Warsaw, Poland

    Konrad Slynarski

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Luboinski, L., Pasieczny, M., Ulicki, P., Albrewczyński, T. (2021). Anatomy, Surgical Management, and Postoperative Outcomes of Acetabular Labral Tears. In: Brittberg, M., Slynarski, K. (eds) Lower Extremity Joint Preservation. Springer, Cham. https://doi.org/10.1007/978-3-030-57382-9_3

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