PMID- 36587762 OWN - NLM STAT- MEDLINE DCOM- 20230523 LR - 20230523 IS - 1877-0568 (Electronic) IS - 1877-0568 (Linking) VI - 109 IP - 4 DP - 2023 Jun TI - Labral tears in hip dysplasia and femoroacetabular impingement: A systematic review. PG - 103539 LID - S1877-0568(22)00412-1 [pii] LID - 10.1016/j.otsr.2022.103539 [doi] AB - INTRODUCTION: Hip dysplasia and femoroacetabular impingement are pathologies whose impact on the function and survival of the hip joint is no longer debated. Labral tears may be present and impact the prognosis of the causal pathology. Labral tear management lacks consensus and still raises several questions, thus we conducted a systematic analysis to clarify: 1) What is its prevalence in hip dysplasia and femoroacetabular impingement? 2) Does it modify the symptomatology of the causal pathology? 3) Is its repair better than resection or abstention? MATERIAL AND METHOD: A systematic literature review was carried out following the PRISMA guidelines, using the Medline and Embase databases and including all articles in French or English, written until June 2022 referring to labral tears in hip dysplasia and femoroacetabular impingement. The articles were analyzed by 2 surgeons in order to select them according to a predefined algorithm. 1) Articles were selected by title from the search results. 2) A selection based on the abstract was then made. 3) A final selection was made upon complete reading. 4) In the event of a discrepancy during the selection, a third co-author was contacted for a final decision. 5) Data extraction was then carried out by the two readers using a preformatted sheet. RESULTS: Of the 1177 articles identified, 43 articles were kept for the final analysis. The prevalence of labral tears was on average 78.80+/-4.7% [17 to 100%] in dysplasia and 93.8+/-16.8% [33% to 100%] in impingement. The review did not reveal any symptomatology specific to the labral tear. In dysplasia, 5 comparative studies were analyzed. A single study on shelf arthroplasties demonstrated the negative impact of a labral tear in the event of resection on survival compared to no tear (83% versus 15.2% (p=0.048)). Regarding impingements, 8 comparative studies were analyzed. At 7 years of follow-up, only one study found a significant and clinically relevant functional gain in terms of MCID (minimal clinically important difference) for labral repair compared to debridement on the mHHS score (p=0.008), SF-12 score (p=0.012), and pain scale (p=0.002). One study showed superiority of repair over labral debridement in terms of 10-year survival (78% 95% CI [64-92%] vs 46% 95% CI [26-66%] (p=0.009)). DISCUSSION: The literature analysis was heterogeneous with a few comparative studies and predominantly short periods of follow-up. Understanding labral pathology and its impact requires differentiating between the different tear categories and proposing treatment to restore or preserve the biomechanical properties of the joint. LEVEL OF EVIDENCE: IV, Systematic Review of Level 1-4 Evidence. CI - Copyright (c) 2022. Published by Elsevier Masson SAS. FAU - Savoye-Laurens, Timothee AU - Savoye-Laurens T AD - Service d'Orthopedie, CHU Dijon-Bourgogne, 12, boulevard Marechal de Lattre de Tassigny 21000 Dijon, France. FAU - Verdier, Nicolas AU - Verdier N AD - Clinique Jean Villar, 2, avenue de Terrefort 33520 Bruges, France. FAU - Wettstein, Michael AU - Wettstein M AD - ITOLS Clinique La Prairie Medical Services, avenue du Theatre 1, 1005 Lausanne, Switzerland; Hopital de Rennaz HRC, Route du Vieux-Sequoia 20, 1847 Rennaz, Switzerland. FAU - Baulot, Emmanuel AU - Baulot E AD - Service d'Orthopedie, CHU Dijon-Bourgogne, 12, boulevard Marechal de Lattre de Tassigny 21000 Dijon, France; Unite INSERM CAPS 1093, Universite de Bourgogne, Faculte des Sciences du Sport (UFR Staps), 3, allee des Stades Universitaires, BP 27877, Dijon, France. FAU - Gedouin, Jean-Emmanuel AU - Gedouin JE AD - Hopital prive du confluent, 2-4, rue Eric Tabarly, 44000 Nantes, France. FAU - Martz, Pierre AU - Martz P AD - Service d'Orthopedie, CHU Dijon-Bourgogne, 12, boulevard Marechal de Lattre de Tassigny 21000 Dijon, France; Unite INSERM CAPS 1093, Universite de Bourgogne, Faculte des Sciences du Sport (UFR Staps), 3, allee des Stades Universitaires, BP 27877, Dijon, France. Electronic address: martzpierre@icloud.fr. LA - eng PT - Journal Article PT - Review PT - Systematic Review DEP - 20221229 PL - France TA - Orthop Traumatol Surg Res JT - Orthopaedics & traumatology, surgery & research : OTSR JID - 101494830 SB - IM MH - Humans MH - *Femoracetabular Impingement/surgery MH - *Hip Dislocation/surgery MH - Treatment Outcome MH - Hip Joint/surgery MH - Follow-Up Studies MH - *Hip Dislocation, Congenital MH - Rupture MH - Arthroscopy/methods MH - Retrospective Studies OTO - NOTNLM OT - Femoroacetabular Impingement OT - Hip Dysplasia OT - Labral Tear OT - Review EDAT- 2023/01/02 06:00 MHDA- 2023/05/23 06:42 CRDT- 2023/01/01 19:13 PHST- 2022/04/09 00:00 [received] PHST- 2022/09/13 00:00 [revised] PHST- 2022/09/19 00:00 [accepted] PHST- 2023/05/23 06:42 [medline] PHST- 2023/01/02 06:00 [pubmed] PHST- 2023/01/01 19:13 [entrez] AID - S1877-0568(22)00412-1 [pii] AID - 10.1016/j.otsr.2022.103539 [doi] PST - ppublish SO - Orthop Traumatol Surg Res. 2023 Jun;109(4):103539. doi: 10.1016/j.otsr.2022.103539. Epub 2022 Dec 29.