Clinical Orthopaedics and Related Research®

, Volume 469, Issue 3, pp 831–838

CT Reveals a High Incidence of Osseous Abnormalities in Hips with Labral Tears

  • Mark M. Dolan
  • Benton E. Heyworth
  • Asheesh Bedi
  • Gavin Duke
  • Bryan T. Kelly
Clinical Research

Abstract

Background

Acetabular labral tears are being diagnosed with increasing frequency and there is a growing consensus that these tears rarely occur in the absence of osseous abnormalities.

Questions/purposes

We therefore determined the presence of structural abnormalities in patients with acetabular labral tears using a standardized CT protocol.

Methods

We evaluated 135 consecutive patients with labral tears diagnosed by MRI with CT scans of the symptomatic hip. The CT scans were evaluated in a standardized fashion to determine acetabular and femoral pathomorphologic features. Acetabular evaluation included version measurements and anterior and lateral center-edge angles. Femoral parameters evaluated included version, alpha angle, and neck-shaft angle.

Results

One hundred twenty-two (90%) of the 135 hips had structural abnormalities. One hundred two (76%) had an alpha angle greater than 50°, 18 (13%) had femoral version less than 5°, 22 (16%) had femoral version greater than 25º, and five (4%) had coxa valga. Fifty-eight (43%) patients had acetabular retroversion and five (4%) had a lateral center-edge angle less than 20º. Of the 58 patients with acetabular retroversion, 23 had isolated cranial retroversion, 12 had isolated central retroversion, and 23 had combined cranial and central retroversion. Sixty-seven of the 121 hips (55%) with bony abnormalities had a combination of abnormalities.

Conclusions

Ninety percent of patients with labral tears had structural abnormalities seen on CT scans. These structural abnormalities frequently occur in combination, and understanding these underlying morphologic features of the hip can help guide treatment.

Level of Evidence

Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • Mark M. Dolan
    • 1
    • 2
  • Benton E. Heyworth
    • 3
  • Asheesh Bedi
    • 4
    • 5
  • Gavin Duke
    • 6
  • Bryan T. Kelly
    • 7
  1. 1.Department of Orthopaedic SurgeryNorthwestern University Feinberg School of MedicineChicago USA
  2. 2.Northwestern Orthopaedic InstituteChicagoUSA
  3. 3.Department of Sports MedicineMassachusetts General HospitalBostonUSA
  4. 4.Sports Medicine & Shoulder SurgeryUniversity of MichiganAnn ArborUSA
  5. 5.Department of Orthopaedic SurgeryUniversity of MichiganAnn ArborUSA
  6. 6.New York Presbyterian HospitalNew YorkUSA
  7. 7.Center for Hip Pain & Preservation Hospital for Special SurgeryNew YorkUSA

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