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Delamination Cysts: A Predictor of Acetabular Cartilage Delamination in Hips with a Labral Tear

  • Original Article
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Clinical Orthopaedics and Related Research

Abstract

The treatment and prognosis of labral tears of the hip depend primarily on whether there is concomitant injury of the adjacent acetabular articular cartilage. We asked whether a delamination cyst on the preoperative plain radiographs correlated with delamination of the acetabular articular cartilage at the time of hip arthroscopy. We reviewed the preoperative radiographs of 125 consecutive hips that had a labral tear at hip arthroscopy for the presence of a delamination cyst. A delamination cyst was defined as an acetabular subchondral cyst either directly adjacent to a lateral acetabular cyst or in relation to a subchondral crack in the anterosuperior portion of the acetabulum. All patients with acetabular cartilage delamination at arthroscopy were identified. There were 16 patients with delamination cysts on radiographs and 15 patients with cartilage delamination at arthroscopy. A delamination cyst on the preoperative anteroposterior and/or frog lateral radiographs of the hip accurately predicted acetabular cartilage delamination, especially in hips with labral tears not caused by a major trauma. A delamination cyst is a previously unrecognized and novel radiographic sign that can preoperatively identify acetabular cartilage delamination in patients with labral tears, thereby facilitating the selection of the appropriate surgery and determining prognosis.

Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, McGill University, 1650 Cedar Avenue #B5159, Montreal, QC, Canada, H3G 1A4

    Marie Gdalevitch MD, Karen Smith CRA & Michael Tanzer MD

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  1. Marie Gdalevitch MD
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  2. Karen Smith CRA
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  3. Michael Tanzer MD
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Correspondence to Michael Tanzer MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has either waived or does not require approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Gdalevitch, M., Smith, K. & Tanzer, M. Delamination Cysts: A Predictor of Acetabular Cartilage Delamination in Hips with a Labral Tear. Clin Orthop Relat Res 467, 985–991 (2009). https://doi.org/10.1007/s11999-008-0564-1

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  • DOI: https://doi.org/10.1007/s11999-008-0564-1

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