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Erschienen in:
01.09.2014 | Original Article
Factors contributing to the failure of conservative treatment for acetabular labrum tears
Erschienen in: European Orthopaedics and Traumatology | Ausgabe 3/2014
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Background
Athroscopic treatment of acetabular labral tears is commonly performed for these patients. However, conservative treatment is generally considered to be the first choice of the treatment.
Purpose
We analyzed the clinical and radiological factors contributing to failure of conservative treatment of acetabular labral tears.
Methods
In this study, 75 patients (82 hips) with positive physical symptoms and radiologic evidence of labral tears were enrolled. All patients underwent conservative treatment for at least 6 weeks. Surgical treatment was carried out if the hip pain was not completely relieved. Clinical and radiological factors contributing to failure of conservative treatment were evaluated using univariate and multivariate analysis.
Results
There were 37 patients who improved with nonsurgical treatment, and the remaining patients (47 hips) underwent surgery (6 periarticular osteotomy, 11 partial debridement, and 28 labral refixation). Multivariate analysis indicated that the factor contributing to the response to conservative treatment was a tear of the ligamentum teres (p < 0.01). Those with tears of the ligamentum teres were 16.2 times (95 % CI, 5.39–49.1) more likely to undergo surgical treatment.
Conclusion
We identified a torn ligamentum teres as a factor contributing to the poor response to conservative treatment. Patients with a torn ligamentum teres develop subtle hip microinstability. Such microinstability may play a critical role in the pathogenesis of intra-articular lesions of the hip joint.