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

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related 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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Acknowledgments

We thank Steven Albert MD, Douglas Decorato MD, and Robert Ludwig MD for assistance in evaluating CT scans for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago , IL, USA

    Mark M. Dolan MD

  2. Northwestern Orthopaedic Institute, 680 North Lake Shore Drive Suite 924, Chicago, IL, 60611, USA

    Mark M. Dolan MD

  3. Department of Sports Medicine, Massachusetts General Hospital, Boston, MA, USA

    Benton E. Heyworth MD

  4. Sports Medicine & Shoulder Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi MD

  5. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi MD

  6. New York Presbyterian Hospital, East River Imaging, New York, NY, USA

    Gavin Duke MD

  7. Center for Hip Pain & Preservation, Hospital for Special Surgery, New York, NY, USA

    Bryan T. Kelly MD

Authors
  1. Mark M. Dolan MD
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  2. Benton E. Heyworth MD
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  3. Asheesh Bedi MD
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  4. Gavin Duke MD
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  5. Bryan T. Kelly MD
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Corresponding author

Correspondence to Mark M. Dolan MD.

Additional information

One or more of the authors (BTK) is a paid consultant for Pivot Medical, Inc, Smith & Nephew, and Shriners Hospitals for Children Clinical Outcomes Studies Advisory Board and holds stock or stock options in Pivot Medical, Inc and Smith & Nephew. One or more of the authors (AB) is a paid consultant for Smith & Nephew.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at the Hospital for Special Surgery, New York, NY, USA.

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Dolan, M.M., Heyworth, B.E., Bedi, A. et al. CT Reveals a High Incidence of Osseous Abnormalities in Hips with Labral Tears. Clin Orthop Relat Res 469, 831–838 (2011). https://doi.org/10.1007/s11999-010-1539-6

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  • DOI: https://doi.org/10.1007/s11999-010-1539-6

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