Abstract
Purpose: Acetabular labral tears are most commonly associated with minor or atraumatic events. As a result, it is likely that these tears occur in the presence of an abnormal hip joint. The purpose of this investigation was to establish whether anterior hip impingement, secondary to an anterior femoral offset deficiency from a pistol grip deformity, was a common and poorly recognized cause of acetabular labral tears.
Methods: Sixty-five consecutive patients who underwent a hip arthroscopy and were found to have a labral tear were evaluated. Preoperative hip radiographs were evaluated for abnormalities of the femur and /or acetabulum. The patient’s outcome with respect to resolution to pain and mechanical symptoms was assessed.
Results: All labral tears identified at the time of hip arthroscopy were found to be located anteriorly. A pistol grip deformity of the proximal femur was identified on the preoperative radiographs in 92% of the patients. Labral excision resulted in complete resolution of hip pain in only 8 (28%). With the remaining 72% experiencing mild or moderate pain.
Conclusions: Acetabular labral tears are the result of repetitive femoral-acetabular impingement, from a pistol grip deformity, with eventual tearing of the labrum from a relatively minor trauma. This is analogous to a rotator cuff repair in the shoulder that is secondary to repetitive impingement by the acromium. Decompression or correction of the anterior hip impingement should routinely be considered at the time of labral surgery to provide complete relief of symptoms and diminish the risk of future joint degeneration.
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
