Prevalence and clinical significance of hypertrophic labrum in non-dysplastic hips.
BACKGROUND
Hypertrophic labrum in dysplastic hip has been frequently reported and is known as limbus in developmental dysplasia of the hip. However, hypertrophic labrum without hip dysplasia has not been reported to date. The purpose of this study was to define hypertrophic labrum and to investigate the prevalence and clinical significance of an abnormally hypertrophic labrum in non-dysplastic hips.


METHODS
Between 2007 and 2014, direct CT arthrography was performed in 464 patients (470 hips) who had chronic groin pain and positive impingement or Faber test. There were 189 male (192 hips) and 275 female (278 hips) patients. The mean age was 46.8 years (range, 16-74 years). The hypertrophic labrum was defined as a labrum wider than two standard deviations away from the mean. Surgical correlation of hypertrophic labrum was obtained in cases with hip arthroscopy by a single surgeon.


RESULTS
Seventeen hips (3.6%) were found to have a hypertrophic labrum which had a mean width of 11.2 mm (±1.1) (range, 9.8-14.1 mm). The average width (±SD) of the labrum without hypertrophy was 5.5 mm (±2.4) (range, 2-9.8 mm). Arthroscopic findings of the hypertrophic labrum included fissure and longitudinal tear at the chondrolabral junction and they were associated with chondral abnormality adjacent to the lesion.


CONCLUSIONS
Hypertrophic labrum without hip dysplasia is not rare with a high incidence of tears. Care should be taken during arthroscopic access to the hip joint in patients with this morphologic variation as iatrogenic damage can occur more easily.


METHODS
Case Series; Level IV.
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, South Korea. Electronic address: hayongch@naver.com.
Yong-Chan
YC
Ha
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi-do 463-707, South Korea. Electronic address: ykleemd@gmail.com.
Young-Kyun
YK
Lee
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi-do 463-707, South Korea. Electronic address: khkoo@snu.ac.kr.
Kyung-Hoi
KH
Koo
Department of Orthopaedic Surgery, Seonam University College of Medicine Myongji Hospital, 55 Hwasu-ro 14beon-gil, Deokyang-gu, Goyang-si, Gyeonggi-do 412-826, South Korea. Electronic address: medibom@naver.com.
Ki-Bum
KB
Kwon
Department of Orthopaedic Surgery, Seonam University College of Medicine Myongji Hospital, 55 Hwasu-ro 14beon-gil, Deokyang-gu, Goyang-si, Gyeonggi-do 412-826, South Korea. Electronic address: sh.gabriel.song@gmail.com.
Sang-Heon
SH
Song
D000293:Adolescent; D000328:Adult; D000368:Aged; D001175:Arthrography / Q000379:methods; D001182:Arthroscopy; D005260:Female; D057925:Femoracetabular Impingement / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D051445:Fibrocartilage / Q000000981:diagnostic imaging*; D006617:Hip Dislocation; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult