Acetabular Delamination: Epidemiology, Histological Features, and Treatment

Overview

Journal Cartilage

Date 2018 Apr 10

PMID 29629574

Citations 17

Authors

Eugenio Jannelli

Antonina Parafioriti

Alberto Acerbi

Alessandro Ivone

Alberto Fioruzzi

Andrea Fontana

Affiliations

Soon will be listed here.

Abstract

Objective: The International Cartilage Repair Society classification is the one mainly used to define chondral defects. However, this classification does not include delamination. The objective of the study is to describe the characteristics of this lesion to better explain its classification in the context of chondral lesions of the hip.

Design: We performed a retrospective analysis of 613 patients who underwent hip arthroscopy. In this group, the incidence, localization, histological characteristics, and association to femoroacetabular impingement as well as to other intraarticular lesions of acetabular delamination (AD) were analyzed. Preoperative magnetic resonance imaging accuracy and the different treatment options were also evaluated.

Results: In our series, the incidence of the AD was 37% (226 patients over 613). The average age of this group was significantly lower (39.3 years) than the entire group of patients. Isolated cam ( < 0.01) and pincer morphologies ( < 0.05) had a significant statistical association with the AD. This lesion was primarily localized at the acetabular chondrolabral junction, mainly on the anterosuperior quadrant. The intraarticular lesions more frequently associated to AD were labral lesions (94.25%, < 0.01), ligamentum teres lesions (28.32%, < 0.05), and femoral head chondral lesions (19.9%, < 0.01). The histological examination of the AD was characterized by hypocellularity and structural disorder of the matrix, with fissures. Treatment remains controversial.

Conclusion: AD represents an intermediate stage in chondral damage and can be classified as a "2a" grade lesion. Histological examination confirms the intermediate and progressive character of this injury.

Citing Articles

Current understanding of articular cartilage lesions in femoroacetabular impingement syndrome.

Li Z, Yu J, An P, Zhang W, Tian K J Orthop Surg Res. 2024; 19(1):886.

PMID: 39734214 PMC: 11684245. DOI: 10.1186/s13018-024-05322-6.

Arthroscopic Repair of Acetabular Cartilage Delamination Using Chondral Nail Fixation in Patients With Femoroacetabular Impingement.

Dong H, Tian K, Gao G, Liu R, Zhang S, Liu Z Arthrosc Tech. 2024; 13(5):102950.

PMID: 38835465 PMC: 11144942. DOI: 10.1016/j.eats.2024.102950.

Comparison of MRI and arthroscopy findings for transitional zone cartilage damage in the acetabulum of the hip joint.

Markhardt B, Hund S, Rosas H, Symanski J, Mao L, Spiker A Skeletal Radiol. 2024; 53(7):1303-1312.

PMID: 38225402 DOI: 10.1007/s00256-024-04563-0.

Accuracy of Magnetic Resonance Imaging in the Diagnosis of Acetabular Chondral Delamination in Femoroacetabular Impingement.

Gao G, Dong H, Wang J, Ao Y, Xu Y Orthop J Sports Med. 2022; 10(8):23259671221119225.

PMID: 36051975 PMC: 9424888. DOI: 10.1177/23259671221119225.

Chondral delamination of the knee and its management: a case report and review article.

Mansour M, Abboud Y, Alhaffar M, Souliman O, Haffar M, Mustafa Y BMC Surg. 2022; 22(1):325.

PMID: 36038865 PMC: 9422128. DOI: 10.1186/s12893-022-01775-w.

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