Labrum lesion and residual dysplasia in the hip

Labral lesions are a sign of biomechanical decompensation of the hip joint and often represent the first clinical symptom of residual hip dysplasia (R HD) in the adult. Provocation tests (impingement, apprehension) are typical but not specific. Labral lesions and concomitant findings (intra- and extr aosseous ganglia, stress bone marrow oedema) can be detected by magnetic re sonance arthrography (MRA) with an accuracy of 91%. Primary therapeutic goa l is the normalization of the underlying pathomorphology and instability by a redirectional acetabular osteotomy. There are several concepts concernin g simultaneous arthrotomy at the time of osteotomy: no arthrotomy at all, s elective arthrotomy, routine arthrotomy in every case. There are more clini cal studies necessary before one of these concepts can be widely accepted a nd recommended. Based on preliminary results, palliative arthrotomy with pa rtial labral resection but without corrective osteotomy in osteoarthritis s econdary to residual hip dysplasia gives poor results; we therefore urgentl y dissuade from palliative labral surgery via arthrotomy. Whether labral su rgery via arthroscopy might be a useful concept in symptomatic residual hip dysplasia, is still an open question. In this review article, the "state o f the art" presented at the "Vienna Labral Symposium 1997" is reflected and summarized. At the end of this article, a "common statement" of the expert s is published in English and German language.