EP1.60 Re-examining the association between labral size and hip dysplasia: Does a clear trend emerge?

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ID: 331325
2026
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Abstract
Abstract Background Labral hypertrophy has been described as a compensatory response to increased joint forces encountered in developmental dysplasia and has been previously reported as an intra-operative sign of instability. Anecdotal evidence, however, suggests that patients with hip dysplasia may present with a spectrum of labral size, ranging from hypo- to hypertrophic. This study aims to evaluate intraoperative labral size in patients with hip instability, with a hypothesis that labral size will have a bimodal distribution in patients undergoing periacetabular osteotomy (PAO) for hip dysplasia. Methods A retrospective review of patients undergoing primary PAO was conducted; exclusion criteria included previous ipsilateral hip surgery, traumatic hip fracture, Ehlers-Danlos syndrome, and/or Tonnis Grade ≥2. Intraoperative labral size/diameter at 12:00 and 3:00 were collected and patients were grouped as hypotrophic (<4 mm), normal (4-6 mm), and hypertrophic (>6 mm) if either position met the cutoff. Ordinary least squared (OLS) models were used to assess associations between labral size and demographics and to evaluate differences between groups. Future analyses will include radiographic measurements. Results Sixty-six patients (69 hips; 62 females, 4 males) with a mean age of 29.7±11.8 years and BMI 23.9±5.7 kg/m2 were analyzed. Of the 69 hips, 19% of labra were hypotrophic (13 hips), 58% normovolemic (40 hips), and 23% hypertrophic (16 hips). Labral size/diameter at 12:00 and 3:00 were positively associated with weight (p≤0.001) and BMI (p=0.024, p=0.011), respectively. Labral size was not significantly associated with age and patient height. Between group comparisons demonstrated the hypertrophic group had higher weight and BMI than the normal (weight p=0.016, BMI p<0.001) and hypotrophic (weight p=0.00, BMI p <0.001) groups. Conclusion Preliminary analysis revealed a spectrum of labral size/diameter in dysplastic hips undergoing primary PAO. The majority of hips had a normal sized labrum (58%), with a near equal percentage of hips demonstrating hypo- and hypertrophic labra (19% vs 23%), respectively. These findings contrast previous literature suggesting that increased labral size correlates with hip instability. Further, the positive association between hypertrophic labra and increased patient weight and BMI suggests that these patient-specific factors may play a more important role than dysplasia in predicting labral size.
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Authors Kelly Mardaus, Briana Rowe, Lauren M. Heylmun, Michael B. Ellman, James Genuario
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.244
URL
https://doi.org/10.1093/jhps/hnag043.244
Keywords Keywords not found

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