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Diagnosis and treatment of Acetabular Labrum Tears

Erik Walder URI Department of Electrical, Computer, and Biomedical Engineering BME 181. Diagnosis and treatment of Acetabular Labrum Tears. What is the Acetabular Labrum . A ring of fibrocartilage Attached to the acetabulum Is an extension of the hip socket. Why is it Important?.

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Diagnosis and treatment of Acetabular Labrum Tears

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  1. Erik Walder URI Department of Electrical, Computer, and Biomedical Engineering BME 181 Diagnosis and treatment of Acetabular Labrum Tears

  2. What is the Acetabular Labrum • A ring of fibrocartilage • Attached to the acetabulum • Is an extension of the hip socket

  3. Why is it Important? Force Distribution On Hip Joint • Helps to distribute the load the hip joint bears • Deepens the hip joint • Provides increased stability to the hip joint • Decreases friction within the hip joint Acetabulum

  4. Common Causes of Tears • usually torn when the hip is bearing a load and is twisted suddenly • Trauma to the hip can also cause a tear • Some things can cause the labrum to tear more easily

  5. Pre-dispositions to Labrum Tears • Hip dysplasia • Places more stress on the labrum • More movement in the femoral head makes a tear more likely • hip degeneration • Weakened or arthritic hips make tears more likely

  6. Symptoms of a Labrum Tear • Pain is not usually felt directly in hip joint • Can feel like a strained groin, quadriceps, or back muscle • a catching or clicking sensation in the hip • Hips suddenly ‘giving way’ • Pain is caused by torn pieces being caught in the hip joint

  7. Diagnosis of a Labrum Tear • A labrum tear usually has little to no impact on the range of motion • Computer Tomography (CT), Magnetic Resonance Imaging (MRI), and X-Rays will NOT detect a tear • A Magnetic Resonance Arthrogaphy (MRa) in addition to a physical examination is effective • Still cannot be 100% diagnosed until in surgery

  8. Arthrogram / MRa • Contrast is injected into the actual labrum • This procedure (Arthrogram) takes anywhere from 15-45 minutes • The Patient then undergoes an MRI • Contrast leaks from the tears, making them visible

  9. Repair • Labrum is not actually repaired • No blood vessels = No Growth / Regeneration • Surgeons clean any loose tissues out of the joint • Torn areas are then removed • The labrum is then ‘sculpted’ until it has a smooth surface and edge again • Removing torn tissue means less pain

  10. Drawbacks to Repair of labrum • Less cartilage means more stress on acetabulum and femoral head • Arthritis develops earlier • Caused by more friction in the joint • Full hip replacement at an earlier age • Benefits far outweigh the drawbacks

  11. Arthroscopic Surgery • Three incisions about one centimeter in diameter are made around the hip region • Tubes are inserted into each of the incisions to make transferring tools between incisions easier • A fiber optic camera allows the surgeon to see inside the joint • Specialized cutting and suction tools are used • Minimally Invasive

  12. Surgical Equipment Arthroscope Traction Table Arthroscope • Arthroscope • Fiber optic Camera, Cutting tools, Suction Tools • Traction Table • Pulls Hip slightly out of Joint • Live X-Ray • Help Surgeons see that they are in the right area C-Arm X-Ray (Live X-Ray)

  13. Recovery • Large Muscle Groups are not severed • Much Shorter recovery time (1-2 Months) • Partial Weight Bearing possible earlier than conventional surgery • Small Incisions mean less risk of infection • Much easier and shorter recovery than conventional open hip surgery

  14. References of Pictures Used • <http://www.conservativehipsolutions.com/images/anterior_hip_joint_small.jpg> • <http://graphics8.nytimes.com/images/2009/06/01/sports/ • 0601-spt-WebHIP.gif> • <http://www.thefinalsprint.com/images/2007/05/hip.JPG> • <http://www.lawyersandsettlements.com/blog/wp-content/uploads/2009/08/mri-image.jpg> • <http://www2.imperial.ac.uk/structuralbiomechanics/projects/freebcpelvis/fixed_vm_S2S.png> • <http://americanpitbullregistry.com/images/hip%20dysplasia.jpg> • <http://littleastonoasis.com/HipArthroscopy.aspx> • <http://www.biztrademarket.com/User/174576/bb/jpx-c101-1_gbn.jpg>

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