Toshihiko Ikeda

Torn acetabular labrum in young patients. Arthroscopic diagnosis and management

Arthroscopy of the hip revealed a torn acetabular labrum in seven young patients. Three of them had had an acute onset of symptoms during sporting activities. On examination all seven patients had pain on passive flexion and medial rotation of the joint. All but one of the tears were located on the posterosuperior portion of the labrum, and, in the acute cases, vascular dilatation around the tear was observed. In these cases, repeated arthroscopy several months later showed that the vascular changes had disappeared, but the tear was still present. The aetiology, diagnosis and treatment of the torn acetabular labrum are discussed.

Arthroscopic diagnosis of ruptured acetabular labrum.

We performed arthroscopy in nine hips in 8 patients with hip pain of unknown origin. Of them, 5 patients had a rupture in the posterior or posterosuperior labrum, not seen by arthrography. On physical examination the patients complained of pain on both passive flexion and internal rotation of the hip, and when the thigh was pushed backwards at 90 degrees of flexion.

Arthroscopic surgery for synovial chondromatosis of the hip

We report a case in which arthroscopic surgery was successfully performed for synovial chondromatosis of the hip, and report an experience with diagnostic arthroscopy of this joint

Examination by ultrasound of Legg-Calvé-Perthes disease.

Eleven patients with Legg-Calvé-Perthes disease (LCP) were examined ultrasonographically for their femoral head deformity. The outline of the cartilaginous femoral head was well demonstrated, and the image obtained corresponded to that observed by arthrography. Using ultrasonography, a simple method was developed to determine the rate of deformity due to LCP. Ultrasonography does not have the hazards of x-ray and is useful for the diagnosis of LCP.

Diagnosis by ultrasound of congenital dislocation of the hip joint.

Two hundred thirty-four hips of 117 babies from one day to 18 months of age were examined ultrasonographically for congenital dislocation of the hip joint. Ten hips in eight babies were dislocated or subluxated and there were 11 hip dysplasias in seven babies. In the normal hip, the adaptation between the acetabulum and the femoral head is well demonstrated, and there is no apparent interposition of the limbus between the acetabular roof and the cartilaginous head. In the dislocated hip, the protrusion of the acetabular rim is not so clear as that of the normal hip, and the limbus is seen to be interpositioned between the acetabular roof and the cartilaginous head. In severe cases, the acetabular rim is hidden under the shade of the femoral head. Ultrasonography is an effective method of determining the incidence of dislocation and of diagnosing hip subluxation as well as dysplasia and does not have the hazards of x-ray examination.