249
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      A comprehensive review of hip labral tears

      review-article
      ,
      Current Reviews in Musculoskeletal Medicine
      Humana Press Inc
      Hip, Labrum, Labral tear

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The hip labrum has many functions, including shock absorption, joint lubrication, pressure distribution, and aiding in stability, with damage to the labrum associated with osteoarthritis. The etiology of labral tears includes trauma, femoroacetabular impingement (FAI), capsular laxity/hip hypermobility, dysplasia, and degeneration. Labral tears present with anterior hip or groin pain, and less commonly buttock pain. Frequently, there are also mechanical symptoms including clicking, locking, and giving way. The most consistent physical examination finding is a positive anterior hip impingement test. Because of the vast differential diagnosis and the need for specialized diagnostic tools, labral tears frequently go undiagnosed during an extended period of time. Evaluation usually begins with plain radiographs to assess for dysplasia, degeneration, and other causes of pain. While magnetic resonance imaging (MRI) and computed tomography scans are unreliable for diagnosis, magnetic resonance arthrography (MRA) is the diagnostic test of choice, with arthroscopy being the gold standard. Typically, treatment begins conservatively with relative rest and non-steroid anti-inflammatory agents, with physical therapy (PT) being controversial. Often, surgical treatment is necessary, which entails, arthroscopic debridement of labral tears and surgical repair of associated structural problems.

          Related collections

          Most cited references114

          • Record: found
          • Abstract: found
          • Article: not found

          Femoroacetabular impingement: a cause for osteoarthritis of the hip.

          A multitude of factors including biochemical, genetic, and acquired abnormalities may contribute to osteoarthritis of the hip. Although the pathomechanism of degenerative process affecting the dysplastic hip is well understood, the exact pathogenesis for idiopathic osteoarthritis has not been established. Based on clinical experience, with more than 600 surgical dislocations of the hip, allowing in situ inspection of the damage pattern and the dynamic proof of its origin, we propose femoroacetabular impingement as a mechanism for the development of early osteoarthritis for most nondysplastic hips. The concept focuses more on motion than on axial loading of the hip. Distinct clinical, radiographic, and intraoperative parameters can be used to confirm the diagnosis of this entity with timely delivery of treatment. Surgical treatment of femoroacetabular impingement focuses on improving the clearance for hip motion and alleviation of femoral abutment against the acetabular rim. It is proposed that early surgical intervention for treatment of femoroacetabular impingement, besides providing relief of symptoms, may decelerate the progression of the degenerative process for this group of young patients.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip.

            Recently, femoroacetabular impingement has been recognised as a cause of early osteoarthritis. There are two mechanisms of impingement: 1) cam impingement caused by a non-spherical head and 2) pincer impingement caused by excessive acetabular cover. We hypothesised that both mechanisms result in different patterns of articular damage. Of 302 analysed hips only 26 had an isolated cam and 16 an isolated pincer impingement. Cam impingement caused damage to the anterosuperior acetabular cartilage with separation between the labrum and cartilage. During flexion, the cartilage was sheared off the bone by the non-spherical femoral head while the labrum remained untouched. In pincer impingement, the cartilage damage was located circumferentially and included only a narrow strip. During movement the labrum is crushed between the acetabular rim and the femoral neck causing degeneration and ossification. Both cam and pincer impingement lead to osteoarthritis of the hip. Labral damage indicates ongoing impingement and rarely occurs alone.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis.

              Surgical dislocation of the hip is rarely undertaken. The potential danger to the vascularity of the femoral head has been emphasised, but there is little information as to how this danger can be avoided. We describe a technique for operative dislocation of the hip, based on detailed anatomical studies of the blood supply. It combines aspects of approaches which have been reported previously and consists of an anterior dislocation through a posterior approach with a 'trochanteric flip' osteotomy. The external rotator muscles are not divided and the medial femoral circumflex artery is protected by the intact obturator externus. We report our experience using this approach in 213 hips over a period of seven years and include 19 patients who underwent simultaneous intertrochanteric osteotomy. The perfusion of the femoral head was verified intraoperatively and, to date, none has subsequently developed avascular necrosis. There is little morbidity associated with the technique and it allows the treatment of a variety of conditions, which may not respond well to other methods including arthroscopy. Surgical dislocation gives new insight into the pathogenesis of some hip disorders and the possibility of preserving the hip with techniques such as transplantation of cartilage.
                Bookmark

                Author and article information

                Contributors
                +1-516-220-0405 , yankegirl8@yahoo.com
                Journal
                Curr Rev Musculoskelet Med
                Current Reviews in Musculoskeletal Medicine
                Humana Press Inc (New York )
                1935-973X
                1935-9748
                7 April 2009
                7 April 2009
                June 2009
                : 2
                : 2
                : 105-117
                Affiliations
                Physical Medicine & Rehabilitation, Mount Sinai Hospital, New York, NY USA
                Article
                9052
                10.1007/s12178-009-9052-9
                2697339
                19468871
                af0684da-a078-4b95-87ac-709e0c336963
                © The Author(s) 2009
                History
                : 7 March 2009
                : 12 March 2009
                Categories
                Article
                Custom metadata
                © Humana Press 2009

                Orthopedics
                hip,labrum,labral tear
                Orthopedics
                hip, labrum, labral tear

                Comments

                Comment on this article