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Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017)

24.10. - 27.10.2017, Berlin

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Is Acetabular Labrum size and tear pattern associated with femoral retrotorsion or increased femoral torsion in patients with FAI?

Meeting Abstract

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  • presenting/speaker Inga Todorski - Inselspital, University Hospital Bern, Klinik für Orthopädische Chirurgie und Traumatologie, Bern, Switzerland
  • Till Lerch - Inselspital, University Hospital Bern, Klinik für Orthopädische Chirurgie und Traumatologie, Bern, Switzerland
  • Florian Schmaranzer - Inselspital, University Hospital Bern, Klinik für Orthopädische Chirurgie und Traumatologie, Bern, Switzerland
  • Klaus Siebenrock - Inselspital, University Hospital Bern, Klinik für Orthopädische Chirurgie und Traumatologie, Bern, Switzerland
  • Simon Damian Steppacher - Inselspital, University Hospital Bern, Klinik für Orthopädische Chirurgie und Traumatologie, Bern, Switzerland
  • Moritz Tannast - Inselspital, University Hospital Bern, Klinik für Orthopädische Chirurgie und Traumatologie, Bern, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocIN28-151

doi: 10.3205/17dkou072, urn:nbn:de:0183-17dkou0726

Veröffentlicht: 23. Oktober 2017

© 2017 Todorski et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives: Acetabular labrum size and labral tears antero-superior are typical for femoroacetabular Impingement (FAI). Femoral torsion (FT) is a novel cause for anterior FAI and influences labral size and tear pattern.

Therefor we asked

1.
what is the anterior labral size and
2.
which labral tear patterns are associated with femoral retrotorsion compared to hips with elevated FT.

Methods: Out of 620 consecutive MR arthrographies we excluded 491 hips with normal FT. An IRB-approved retrospective radiological study involving 129 hips with symptomatic FAI and abnormal FT was performed. Femoral retrotorsion was defined as FT < 5°(58 hips), elevated FT was defined as >30°(71 hips).

All patients underwent routine radiological evaluation using MR arthrography (3T) including distal femoral condyles for calculation of FT. Labral size and labral tear patterns were measured circumferentially on every clock position (15° intervals) on radial slices trough the femoral neck.

Results:

1.
Anterior labral size was significantly decreased in hips with femoral retrotorsion (14mm2 vs 22mm2, p<0,001) compared to posterior in hips with elevated FT. Labral size was significantly smaller anterior compared to posterior hips with femoral retrotorsion (p<0,001)
2.
Labral tear patterns were more frequently anterior (2 and 3 o'clock, p<0,001) in hips with elevated FT.

Conclusion:

Anterior labrum was smaller in hips with femoral retrotorsion on the corresponding localization of acetabular rim impingement. This has be considered during radiological diagnosis of FAI for hip preserving surgery. Anterior labral tear patterns could be associated with anterior subluxation or instability in hips with elevated FT.