Relationship between labral length and symptoms in patients with acetabular dysplasia before rotational acetabular osteotomy

Abstract

ABSTRACTThe aim of this study was to investigate the relationship between acetabular labral length and symptoms in patients with acetabular dysplasia. In a retrospective medical record review, 218 patients with acetabular dysplasia who had undergone rotational acetabular osteotomy were identified. After implementing the inclusion and exclusion criteria, 53 patients were analyzed for preoperative symptoms measured by the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), acetabular bone morphology parameters by anteroposterior pelvic radiographs and labral parameters by radial magnetic resonance imaging. Spearman’s correlation coefficients were calculated among JHEQ scores, bone morphologic parameters and labral parameters. Multiple linear regression models to determine the predictive variables of JHEQ score and labral length were obtained. There was no correlation between bone morphologic parameters and JHEQ scores. Labral length measured anteriorly correlated with JHEQ pain {r [95% confidence interval (CI)] = −0.335 (−0.555, −0.071), P = 0.014}, movement subscale [r (95% CI) = −0.398 (−0.603, −0.143), P = 0.003], mental subscale [r (95% CI) = −0.436 (−0.632, −0.188), P = 0.001] and total JHEQ score [r (95% CI) = −0.451 (−0.642, −0.204), P = 0.001]. The multiple linear regression results showed that anterior labral length was independently associated with JHEQ subscales in some models. Meanwhile, age, acetabular head index and total JHEQ score were independently associated with anterior labral length in all models. Labral length, notably in anterosuperior area, in patients with symptomatic acetabular dysplasia was related to patient’s symptom. Labral length may be an important objective image finding that can be used to assess the severity of cumulative hip instability.