Acetabular Labral Lesions Always Present in End-Stage Osteoarthritis

The purpose of this pilot study was to explore the relationship between pathologies in the acetabular labrum and end-stage osteoarthritis (OA). The study design was a prospective observational case series of 10 patients undergoing total hip replacement for end-stage OA. The arthroplasty procedure was performed using a standard lateral approach. An arthroscope was used along with a 5-mm probe to examine the labrum and the cartilage on the femoral and acetabular sides. Two blinded hip arthroscopy surgeons viewed the recordings and assessed the presence and location of labral tears and cartilage lesions according tothe Lage and Outerbridge classifications, respectively. The mean age of the 10 patients was 67 years. Labral pathology clustered in the anterior-superior quadrant was detected in all 10 hips. Tear patterns included longitudinal peripheral tears, fissuring, and large unstable tears. Significant inter-observer variability was noted. In all hips with focal acetabular articular lesions (40%), the lesion was located immediately adjacent to the labral pathology. In conclusion, all patients with end-stage OA were found to have a labral tear. The pathology, which was predominantly located in the anterior-superior part, was also a common site of more focal arthritic changes. This suggests that labral tears could be associated with the development of OA, indicating directions for further studies on this connection.