Arthroscopy. 2019 Apr;35(4):1080-1082. doi: 10.1016/j.arthro.2019.01.005.
Most acetabular labral tears are caused by abnormal osseous morphology, such as cam and/or pincer morphology and dysplasia. There is a high prevalence of asymptomatic cam morphology, pincer morphology, dysplasia, and acetabular labral tears in the general population. The addition of subjective patient symptoms and objective physical examination findings to imaging (plain radiographs, magnetic resonance imaging, and computed tomography) may yield the diagnosis of femoroacetabular impingement syndrome. Most glenoid labral tears (e.g., Bankart lesion, posterior labral tear, or SLAP tear) are caused by either glenohumeral instability or a degenerative process. Similarly to the acetabular labrum, there is a high prevalence of asymptomatic glenoid labral tears in an asymptomatic population. Hip pathomorphology (e.g., cam impingement) can have a significant biomechanical impact both upstream and downstream on the kinetic chain (lumbosacral spine, periarticular hip musculature [athletic pubalgia, core muscle injury, sports hernia], knee [anterior cruciate ligament], and shoulder and elbow). Thus, it is tempting to believe that the hip issue may cause the shoulder issue or that an innate genetic (or acquired) abnormality may predispose both joints to labral injury. However, the wise clinician will not be lured into this trap-correlation does not equal causation. Biomechanical studies that evaluate stress transfer from the hip to the shoulder, in addition to clinical studies that prospectively follow these groups, will help to answer this highly relevant question.
大多数髋臼唇撕裂是由异常的骨形态引起的，如凸轮和/或钳子形态和发育不良。在普通人群中，无症状的凸轮形态、钳子形态、发育不良和髋臼唇撕裂的患病率很高。将主观的患者症状和客观的体格检查结果与影像学（平片、磁共振成像和计算机断层扫描）相结合，可能会诊断出髋关节撞击综合征。大多数盂唇撕裂（如 Bankart 损伤、后盂唇撕裂或 SLAP 撕裂）是由肩关节不稳定或退行性过程引起的。与髋臼唇相似，在无症状人群中，无症状的盂唇撕裂的患病率也很高。髋关节形态异常（如凸轮撞击）会对动力链（腰骶脊柱、关节周围髋关节肌肉[运动性耻骨炎、核心肌肉损伤、运动疝]、膝关节[前交叉韧带]和肩部和肘部）产生重大的生物力学影响。因此，人们很容易相信髋关节问题可能导致肩部问题，或者先天的遗传（或后天获得的）异常可能使两个关节都容易受到唇损伤。然而，明智的临床医生不会陷入这个陷阱——相关性并不等于因果关系。评估从髋关节到肩部的应力传递的生物力学研究，以及前瞻性随访这些人群的临床研究，将有助于回答这个非常相关的问题。
