Anatomy, Pathologic Features, and Treatment of Acetabular Labral Tears

There is an evolving body of knowledge regarding the acetabular labrum. Labral tears are most frequently anterior and often are associated with sudden twisting or pivoting motions. High clinical suspicion in association with positive physical findings are fundamental for the clinician to properly determine treatment for the suspected tear. Labral tears, especially those present for years, may contribute to the progression of hip osteoarthritis. Patients at risk include those with developmental dysplasia, those with tears greater than 5 years, and those with associated chondral full-thickness lesions. Chondral injuries may occur in association with a multitude of hip conditions including labral tears, loose bodies, osteonecrosis, slipped capital femoral epiphysis, dysplasia, and degenerative arthritis. Labral tears occurring at the watershed zone may destabilize the adjacent acetabular conditions. Arthroscopic observations support the concept that labral disruption, acetabular chondral lesions, or both frequently are part of a continuum of degenerative joint disease.