The Inverse Relationship Between Labral Size and Acetabular Coverage: Does It Protect the Cartilage in the Dysplastic Hip?
Authors: Shapira J, Chen JW, Yelton MJ, Rosinsky PJ, Maldonado DR, Meghpara MB, Lall AC, Domb BG
DOI: 10.1016/j.arthro.2021.04.052
Background
The acetabular labrum contributes to hip stability and cartilage protection. Its size may vary depending on acetabular coverage, especially in borderline dysplasia.
Methods
The study analyzed labral size and cartilage status in patients with borderline dysplastic hips versus normal hips.
Key Findings
- Larger labral size correlated with increased cartilage damage in borderline dysplastic hips.
- This suggests that a larger labrum may indicate greater joint instability rather than protection.
Conclusions
There is an inverse relationship between acetabular coverage and labral size; in borderline dysplasia, a larger labrum may not be protective but rather a marker of instability and cartilage compromise.
What Does This Mean for Providers?
- Larger labral size in borderline dysplastic hips should prompt careful evaluation of joint stability and cartilage health.
- Providers should recognize that labral hypertrophy may reflect compensatory mechanisms for instability and correlate with worse cartilage damage.
- Treatment plans should consider the complex interplay between labral morphology and acetabular coverage when addressing borderline dysplasia.
- This may influence decisions on surgical techniques such as labral reconstruction or capsular plication to optimize joint stability and cartilage preservation.