Prevalence of acetabular cartilage lesions and labral tears in femoroacetabular impingement

The goal of this study was to determine the prevalence of associated acetabular cartilage lesions and labral tears in patients with cam-type femoro-acetabular impingement (FAI). We evaluated acetabular cartilage lesions and labral tears found during hip arthroscopy in 52 patients with radiological signs of cam-type FAI. We found a high prevalence of associated lesions (86.5%) in patients with cam-type FAI. They were graded according to the morphology, extent, and location of the lesion. Forty-one patients (78.8%) had an acetabular cartilage 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). 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 information can help to define the natural history of cam-type FAI, and to determine appropriate treatment.