Background: Acetabular labral tears in the hip have become an increasingly common finding in active duty members due to improved diagnostic capabilities. This has led to a dramatic increase in operative management despite a lack of evidence to support clear long-term benefits. Literature review demonstrated overwhelmingly positive short-term outcomes for labral repairs; however, scattered case reports exist demonstrating debilitating outcomes in young patients, ultimately resulting in total hip arthroplasty.
Case report: A 27-yr-old pilot originally presented with groin pain. Initial X-ray demonstrated a CAM lesion of the right hip and subsequent MRA showed an acetabular labral tear. The patient underwent open arthrotomy with labral repair and femoroplasty with minimal improvement in symptoms. Repeat imaging over 2 yr showed early onset osteoarthritis with rapid progression and a recurrent labral tear. Due to the significant progression of osteoarthritis, the patient was given the choice between a repeat labral repair and total hip arthroplasty. The patient elected for hip arthrotomy with labral repair and extensive synovectomy, which yielded minimal improvement in symptoms.
Discussion: Acetabular labral tears have become a hot topic in the field of orthopedics as a result of a surge in diagnoses likely due to improvements in imaging, most notably MRAs. This has led to considerable debate regarding how to best manage this condition. The literature overwhelmingly shows positive short-term outcomes for surgical management; however, long-term follow-up studies are lacking. The literature has demonstrated multiple case reports resulting in significant complications as a result of these operations, including chondrolysis and eventual need for total hip arthroplasty. Therefore, patient selection is critical as the population tends to be young and active, and the potential complications can be catastrophic. In any case, it is clear that further research is required.Sardon CJ, Resnick ML. Severe arthritic changes following acetabular labral repair and femoroplasty in an air force pilot. Aerosp Med Hum Perform. 2018; 89(2):147-150.