ACETABULAR CARTILAGE LESIONS AND LABRAL TEARS IN FEMORO-ACETABULAR IMPINGEMENT

Abstract

Background: Cam-type femoroacetabular impingement (FAI) is becoming more recognized. Cartilage lesions of the acetabulum and labral tears are frequently encountered. The goal of this study was to accurately describe and communicate these injuries and thus providing a standard for reporting injury, management, and outcome.

Methods: We evaluated acetabular cartilage lesions and labral tears found during hip arthroscopy in 52 patients with radiological signs of cam-type FAI. They were graded according to the morphology and extent of the lesion. The labral tears were described according to the classification by Lage.

Results: Eleven patients (21.2%) had normal cartilage, 14 (26.9%) had a grade 1, 17 (32.7%) a grade 2, 6 (11.5%) a grade 3, and 4 (7.7%) a grade 4 lesion. Labral tears were found in 31 patients (59.6%). There was a high correlation between age and the presence and extent of acetabular cartilage and labral lesions (r=0.70; p< 0.0001 and r=0.45; p< 0.001 respectively). There was also a high correlation between the extent of the acetabular cartilage lesion and the presence of labral lesions (r=0.62; p< 0.0001).

Conclusion: In our study there was a high prevalence of associated injuries (86.5%) in cam-type FAI. Despite the recognized consequences of associated lesions on treatment and outcome, no classification system includes this aspect of FAI. Based on our findings, we developed a system to grade acetabular cartilage lesions according to their morphology and extent. This should provide the surgeon with a standardized tool to better describe the full extent of the injury and treat it accordingly.