ACETABULAR LABRUM TEARS AND HIP-DYSPLASIA OF THE ADULT

Thirty-seven operatively treated patients with residual acetabular dys plasia without arthritis had a labrum tear in the antero-lateral quadr ant. A sensation of hip locking, or of a ''dead leg'' and episodes of ''giving-way'' were found to predict the presence of the tear. 95% of patients had an acute onset of pain. We treated the patients with a pe riacetabular osteotomy and in 12 cases the tear was repaired with a tr ansosseous suture. We excised the labrum lesion in 21 cases with an ex tended avulsion from the bony rim and 4 tears were not severe enough t o require attention. Twenty-two patients were available for a 4.5-year follow-up (range 2-8 years): 18 patients had no pain, 3 had mild pain and one had severe pain. Final pain outcome was not influenced by int raarticular treatment of the tear. The labrum tear is responsible for a well-defined clinical presentation of hip dysplasia and precedes sec ondary arthrosis. Early diagnosis helps to define the time to perform reconstructive surgery. The treatment consists of improving the covera ge and stability of the femoral head by means of a multiplanar periace tabular osteotomy. The osteotomy unloads the torn fibrocartilage and a llows it to heal by moving it out of the weight-bearing area.