The incidence and clinical significance of the hypertrophic acetabular labrum in non-dysplastic hips

The hypertrophic labrum in dysplastic hips has often been reported in the literature and is known as the limbus in developmental dysplasia of the hip. A hypertrophic labrum without hip dysplasia, however, has not been reported to date. The aim of this study was to define the hypertrophic labrum and to investigate the incidence and clinical significance of an abnormally hypertrophic labrum in non-dysplastic hips.
Between 2007 and 2014, CT arthrography was performed in 464 patients who had chronic groin pain and a positive impingement or Faber sign. There were 189 men (192 hips) and 275 women (278 hips). The mean age was 46.8 years (range 16 to 74). A hypertrophic acetabular labrum was defined as a labrum that was wider than two standard deviations above the mean. Correlation with the surgical findings was made in the cases that underwent hip arthroscopy by a single surgeon.
17 hips (3.6%) were found to have a hypertrophic labrum, with a mean width of 11.2mm. The mean width of the labra without hypertrophy was 5.5mm. The arthroscopic findings in the hypertrophic labrum included a cleft and a longitudinal tear of the labral-chondral transition zone of the acetabulum, and were associated with an abnormality of the articular cartilage adjacent to the lesion.
The authors concluded that a hypertrophic acetabular labrum without dysplasia is not rare and carries a high incidence of tears. Care should be taken during arthroscopic access to the hip in patients with this morphological variant, because iatrogenic damage occurs very easily.
Source: “Journal of Orthopaedic Science”, February 2017