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The dimensions of the hip labrum can be reliably measured using magnetic resonance and computed tomography which can be used to develop a standardized definition of the hypoplastic labrum

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to examine the existing literature to determine the dimensions of the acetabular labrum, with a focus on hypotrophic labra, including the modalities and accuracy of measurement, factors associated with smaller labra, and any impacts on surgical management.

Methods

Four databases (PubMed, Ovid [MEDLINE], Cochrane Database, and EMBASE) were searched from database inception to January 2020. Two reviewers screened the literature independently and in duplicate. Methodological quality of included papers was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Where possible, data on labral size were combined using a random effects model.

Results

Twenty-one studies (5 level II, 9 level III, 7 level IV) were identified. This resulted in 6,159 patients (6,436 hips) with a mean age of 34.3 years (range 8.4–85). The patients were 67.3% female with an average follow-up of 57.3 months. There was no consistent definition of labral size quoted throughout the literature. The mean width on MRI/MRA was 7.3 mm (95% CI 6.9–7.8 mm), on computed tomography arthrography was 8.7 mm (95% CI 8.0–9.3), and during arthroscopy was 5.0 mm (95% CI 4.9–5.2). Inter-observer reliability was good to excellent in all modalities. Labral hypotrophy may be associated with increased acetabular coverage. Hypertrophic labra were highly associated with acetabular dysplasia (r = − 0.706, − 0.596, − 0.504, respectively; P < 0.001).

Conclusion

Labral width can reliably be measured utilizing imaging techniques including magnetic resonance and computed tomography. The pooled mean labral width was 6.2 mm, and height 4.6 mm. The establishment of a gold-standard of measurement on arthroscopy and advanced imaging would aid in clinical decision-making regarding treatment options for patients presenting with a painful hip, particularly those with hypoplastic labra, and provide radiological guidelines for standardized labrum size classifications.

Level of evidence

Level IV.

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Abbreviations

DDH:

Developmental dysplasia of the hip

FAI:

Femoroacetabular im**ement

MRI:

Magnetic resonance imaging

MRA:

Magnetic resonance arthrography

US:

Ultrasound

CSA:

Cross-sectional area

LCEA:

Lateral centre–edge angle

CEA:

Centre–edge angle

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Funding

No funding was provided for this study.

Author information

Authors and Affiliations

  1. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada

    Madison Walker & Larissa Maini

  2. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, McMaster University Medical Centre, 1200 Main St West, 4E15, Hamilton, ON, L8N 3Z5, Canada

    Jeffrey Kay, Nicole Simunovic & Olufemi R. Ayeni

  3. Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Mikael Sansone

  4. Musculoskeletal Imaging Unit, Imaging Center, Hospital da Luz, Lisbon, Portugal

    Vasco V. Mascarenhas

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  1. Madison Walker
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  2. Larissa Maini
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  5. Vasco V. Mascarenhas
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Contributions

MW participated in the design of the study, carried out the systematic review, extracted data, provided illustrations, and drafted the manuscript. LM carried out the systematic review, extracted data, and drafted the manuscript. JK participated in the design of the study, was the third reviewer for any disagreements, as well as completed the statistical analysis and revised the manuscript. Authors MS, VM, and NS participated in revising the manuscript. OA conceived of the study and participated in the revision of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Olufemi R. Ayeni.

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This study does not contain any studies with human participants or animals performed by any of the authors.

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Walker, M., Maini, L., Kay, J. et al. The dimensions of the hip labrum can be reliably measured using magnetic resonance and computed tomography which can be used to develop a standardized definition of the hypoplastic labrum. Knee Surg Sports Traumatol Arthrosc 29, 1432–1452 (2021). https://doi.org/10.1007/s00167-020-06330-9

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