ePoster #1004 - ISHA Annual Scientific Meeting 2016

Labral Hypertrophy is Associated with Subtle Hip Dysplasia in an Impingement Cohort

Michael Gaudiani, BA, New York, NY UNITED STATES
Mitchell J. Greenberg, MS, Chicago, IL UNITED STATES
Nathan Marsh, MD, New York, NY UNITED STATES
Ernest Loumaine Sink, MD, New York, NY UNITED STATES
Anil Ranawat, MD, New York, NY UNITED STATES

Hospital for Special Surgery, New York, NY, UNITED STATES

FDA Status Cleared

Summary: We found patients with labral hypertrophy display more significant physical and radiologic findings consistent with subtle hip dysplasia than do patients with normal sized acetabular labrums.

Abstract:
Background: There is a common assertion that hypertrophic acetabular labrums are associated with hip dysplasia. This study seeks to identify demographic, physical exam, and radiologic differences among individuals with labral hypertrophy (LH) and those with normal labrums (NL) in an impingement cohort. Our hypothesis is that individuals with labral hypertrophy will demonstrate more findings suggestive of hip dysplasia. Methods: This is a retrospective study based on a consecutive series of 231 hip arthroscopies performed for impingement by a single surgeon over a two and a half year period. Labral hypertrophy was defined as labral width greater than four millimeters as measured at the time of arthroscopy. Patients with LH were matched to a control group with respect to gender, age, and BMI. Data analysis included demographic variables, physical exam findings, and radiologic measurements of hip anatomy. Results: 42 of 231 patients had acetabular labrums greater than 4 mm in width. Of these 42, 39 patients were matched to controls from the normal labrum group. Statistically significant differences identified in the LH group included a smaller radiograph alpha angle (55.6°±9.85 vs. 62.7°±4.47), smaller radiograph CCEA (27.6°±6.00 vs. 31.6°±6.59), smaller CT CCEA (31.8°±5.30 vs. 35.1°±7.67), larger acetabular index (6.61±4.18 vs. 4.14±6.13), and greater preoperative hip internal rotation (13.59°±10.7 vs. 9.34°±6.17). No statistically significant differences were found in the remainder of the physical exam or radiologic parameters evaluated. Conclusion: Our data demonstrate that patients with labral hypertrophy display more significant physical and radiologic findings consistent with subtle hip dysplasia than do patients with normal sized acetabular labrums.