Prevalence and locations of acetabular labral sulcus in patients undergoing arthroplasty for hip fracture.

PURPOSE

This study was performed to determine the prevalence, type, and location of acetabular sulcus, which is known as a normal variant, by intraoperative observation in patients undergoing arthroplasty for a femoral neck or intertrochanteric fracture.

METHODS

The study enrolled 98 patients (98 hips) (mean patient age, 79.1 years; age range, 51 to 92 years) who underwent total hip arthroplasty or hemiarthroplasty because of a femoral neck or intertrochanteric fracture. All patients underwent an arthroscopic examination during surgery to determine the prevalence of acetabular labral tears or sulci. Acetabular labral lesions were classified by type and location. The accuracy of the anatomic analysis was assessed by determining intraobserver and interobserver reproducibilities in 20 patients.

RESULTS

A labral sulcus was present in 45 of 98 patients (46%), and 2 of these 45 had both anterosuperior and posteroinferior sulci. Of the 47 sulci, 18 were due to simple folding, 28 were due to incomplete separation, and 1 was due to complete separation. A labral tear was observed in 72 patients (73%), and 4 patients had 2 unassociated tears of different types. Of the 76 tears, 45 were of the longitudinal type. The most common location for labral sulci and tears was within the 12- to 3-o'clock quadrant (48% and 68%, respectively). There were only a few sulci without labral tears in the 7- to 9-o'clock region. Intraobserver and interobserver correlations were found to be reproducible and reliable.

CONCLUSIONS

Labral sulci were relatively common in this study (46% of patients), and labral sulci and tears were most commonly found in the anterosuperior area. Therefore acetabular labral lesions in the anterosuperior area should be inspected closely to allow for differentiation between labral tears and labral sulci.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.