Surgical Treatment of Acetabular Dysplasia With Labral Tears

Arthroscopy. 2022 Jun;38(6):1764-1765. doi: 10.1016/j.arthro.2022.03.010.


Acetabular dysplasia results in abnormal forces across the hip joint and can result in both labral tears and cartilage degeneration. A continuum exists from classic dysplasia to normal acetabular morphology. Diagnosis is aided by several radiographic measurements and parameters including a lateral center edge angle of less than 20°, an anterior center edge angle of less than 20°, a Sharp's angle of greater than 42°, and a Tonnis angle of greater than 10°, or version abnormalities. When patients with acetabular dysplasia present with intra-articular hip pain, skeletal maturity, and preserved radiographic joint space, a periacetabular osteotomy (PAO) is considered as a surgical treatment option when conservative measures have failed. The Bernese PAO was developed in 1984 as a way for reorienting the acetabulum to restore more normal femoral head coverage and orientation. The long-term results of this procedure have been promising with 10-year and 20-year survivorships of approximately 85% and 60%, respectively. When dysplasia is coupled with a labral tear or other intra-articular pathology including focal chondral damage, ligamentum teres tears, or capsular defects, hip arthroscopy and PAO are performed. Although there is a paucity in the literature of the long-term evidence for the combined procedure, early results indicate improved patient reported outcome measures. Appropriate treatment of borderline hip dysplasia remains controversial.

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / pathology
  • Acetabulum / surgery
  • Hip Dislocation* / diagnostic imaging
  • Hip Dislocation* / pathology
  • Hip Dislocation* / surgery
  • Hip Dislocation, Congenital* / pathology
  • Hip Joint / surgery
  • Humans
  • Osteotomy / methods
  • Retrospective Studies
  • Treatment Outcome