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. 2015 Jan 26;4(1):e35-40.
doi: 10.1016/j.eats.2014.10.003. eCollection 2015 Feb.

Acetabular paralabral cyst: an unusual cause of femoral vein compression

Raj S Kullar  1 , Ashley L Kapron  1 , Daniel Ihnat  2 , Stephen K Aoki  1 , Travis G Maak  1
Affiliations

Acetabular paralabral cyst: an unusual cause of femoral vein compression

Raj S Kullar et al. Arthrosc Tech. .

Abstract

Acetabular labral tears are a known cause of hip pain in the young, active patient. Labral tears can be due to trauma, femoroacetabular impingement, capsular laxity, dysplasia, and degenerative pathology. Paralabral cysts are relatively common in association with labral tears of the hip, with cysts seen on magnetic resonance imaging studies in as many as 50% to 70% of patients with labral tears. In some cases the cysts can become sizeable and cause neurovascular compression. Nonoperative interventions for the management of paralabral cysts in the shoulder and knee have shown high recurrence rates. In the shoulder and knee, arthroscopic debridement of paralabral cysts has shown good results with lower recurrence rates and resolution of neurovascular function. In the hip there is limited literature regarding surgical management of paralabral cysts. We present a surgical technique for arthroscopic decompression of acetabular paralabral cysts combined with labral repair.

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Figures

Fig 1
Fig 1
Preoperative ultrasound showing common femoral vein (FV) occlusion by extrinsic cystic mass.
Fig 2
Fig 2
Magnetic resonance angiogram showing common femoral vein obstruction on right (R) side.
Fig 3
Fig 3
(A) Anteroposterior pelvic radiograph showing a lateral center-edge angle of 26°, a lateral sourcil-edge angle of 17°, and an up-sloping sourcil. (B) 90° Dunn lateral radiograph showing an alpha angle of 52°.
Fig 4
Fig 4
Preoperative computed tomography scan showing an up-sloping sourcil and lateral center-edge angle of 26°.
Fig 5
Fig 5
Preoperative magnetic resonance images showing a paralabral cyst (arrows) originating from a labral tear in the right (R) hip, causing adjacent femoral vein occlusion: (A) axial magnetic resonance slice and (B) sagittal magnetic resonance slice.
Fig 6
Fig 6
(A, B) Labral hypertrophy and associated tear between 2:30 and 3:30 clock-face positions. (C) Labrum after repair.
Fig 7
Fig 7
Cystic fluid was liberated from the paralabral cyst after it was entered with a shaver.
Fig 8
Fig 8
Postoperative ultrasound showing normal flow through the common femoral vein without any signs of obstruction within the window of the probe (cyan line).
See this image and copyright information in PMC

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