Labral Injury: Radiographic Predictors at the Time of Hip Arthroscopy

Purpose: The purpose of this study was to investigate the influence of multiple demographic and radiographic findings on the size of labral tears identified at the time of hip arthroscopy. Methods: Data were prospectively collected for patients treated with arthroscopic labral repair or debridement from February 2008 to August 2011. Preoperative radiographic and demographic data were collected for 392 patients during the study period. Exclusion criteria included revision surgery and previous hip conditions. An anteroposterior pelvic view, 45 degrees Dunn view, and false-profile view were used to measure Tonnis grade, neck-shaft angle, alpha angle, lateral center edge angle (LCEA), anterior center edge angle (ACEA), acetabular inclination, and the extent of crossover sign when present. At the time of surgery, labral tear size and location were documented for all patients, using traditional acetabular clock face nomenclature for sizing. A multiple linear regression analysis was then performed to assess the correlation of radiographic and demographic findings with the size of the labral tear. Results: Regression analysis displayed statistical significance for sex (P<.0001), age (P<.0001), and alpha angle (P = .005) with labral tear size. For female patients, Tonnis grade (P = .0004) and neck-shaft angle (P = .004) correlated with labral tear size. This model accounted for only 26% of variation in labral tear size. Conclusions: Preoperative risk factors for the extent of labral tear size are male sex, increasing age, and increasing alpha angle. Labral tearswere larger in female patients with higher Tonnis grades and lower neck-shaft angles. Measurements of acetabular coverage and version showed no correlation with labral tear size. The majority of labral tear size variation was not accounted for in this model.