Hip arthroscopy for acetabular labral tears

Abstract

The purpose of this study is to better understand the history, physical examination, imaging, and outcome of arthroscopic debridement of acetabular labral tears. We performed a review of all 290 patients who underwent hip arthroscopy at our institution to identify those who have undergone arthroscopic debridement of an acetabular labral tear. Patients were assessed at follow-up by a physician visit or telephone interview and questioned as to pain, mechanical symptoms, activity level, work status, sports ability, and performance of activities of daily living. Patients were followed-up for a minimum of 1 year or until they underwent total hip arthroplasty (THA). All 28 patients meeting the study criteria were available for follow-up (mean age, 41 years; range, 14 to 70 years) at an average of 34 months after surgery (range, 13 to 100 months). Average duration of symptoms before arthroscopy was 25 months. Eighteen (64%) patients were noted to have mechanical symptoms such as clicking or locking. Ten patients were noted to have a specific inciting event that initiated their symptoms. Magnetic resonance imaging identified the labral tear in 5 of 21 (24%) cases; arthrography identified the tear in 1 of 8 (13%). Of the 28 tears identified, there were 12 radial flap, 5 degenerative, 5 bucket handle, 3 horizontal cleavage, and 3 peripheral longitudinal tears. Seventeen were located anteriorly, 7 were located posteriorly, and 4 were located superiorly. Patients were stratified into two groups based on the presence of significant joint arthritis on radiographs. Of those without arthritis, 10 of 14 (71%) had good to excellent results, and 2 patients underwent total hip arthroplasty at an average of 52 months after surgery. Of those with arthritis, 3 of 14 (21%) had good to excellent results, and 6 patients underwent THA at an average of 14 months after surgery. There were three cases of complications consisting of nerve palsies (two sciatic, one pudendal) that resolved completely without any remaining functional or sensory deficits.