This 1991 case series by Klaue, Durnin, and Ganz defines the acetabular rim syndrome as labral detachment from a dysplastic acetabular rim, occurring before radiographic arthritis appears. The authors present 29 operative cases, propose a two-type radiological classification, and establish periacetabular osteotomy with arthrotomy as the preferred treatment.
A young adult with knife-sharp groin pain, hip locking after sitting, and a positive FADIR test has acetabular rim syndrome until proven otherwise — not a hernia, not a nerve entrapment (two patients in this series had unnecessary herniorrhaphies before the diagnosis was made).
Measure the lateral CE angle on AP pelvis and the anterior CE angle on the faux-profil view. A lateral CE angle below 25° or anterior CE angle below 20° demands further workup for labral pathology and consideration of PAO.
Klaue's two-type classification tells you what to expect intraoperatively. Type I hips (incongruent, acetabular radius larger than femoral head) will have soft-tissue labral detachment without bony fragments. Type II hips (congruent but short roof) will have bony rim lesions, os acetabuli bearing articular cartilage, and intraosseous ganglia.
This paper is why we favor PAO over shelf or Chiari procedures when labral pathology is present. Extra-articular coverage operations leave the tear unaddressed and may mask ongoing intra-articular damage. On labral management, repair carried a 17% re-rupture rate and the slowest recovery in this series. The authors caution that long-term consequences of resection were not yet known at publication, a caveat that drove subsequent decades of labral preservation research.
This 1991 case series by Klaue, Durnin, and Ganz defines the acetabular rim syndrome as labral detachment from a dysplastic acetabular rim, occurring before radiographic arthritis appears. The authors present 29 operative cases, propose a two-type radiological classification, and establish periacetabular osteotomy with arthrotomy as the preferred treatment.
A young adult with knife-sharp groin pain, hip locking after sitting, and a positive FADIR test has acetabular rim syndrome until proven otherwise — not a hernia, not a nerve entrapment (two patients in this series had unnecessary herniorrhaphies before the diagnosis was made).
Measure the lateral CE angle on AP pelvis and the anterior CE angle on the faux-profil view. A lateral CE angle below 25° or anterior CE angle below 20° demands further workup for labral pathology and consideration of PAO.
Klaue's two-type classification tells you what to expect intraoperatively. Type I hips (incongruent, acetabular radius larger than femoral head) will have soft-tissue labral detachment without bony fragments. Type II hips (congruent but short roof) will have bony rim lesions, os acetabuli bearing articular cartilage, and intraosseous ganglia.
This paper is why we favor PAO over shelf or Chiari procedures when labral pathology is present. Extra-articular coverage operations leave the tear unaddressed and may mask ongoing intra-articular damage. On labral management, repair carried a 17% re-rupture rate and the slowest recovery in this series. The authors caution that long-term consequences of resection were not yet known at publication, a caveat that drove subsequent decades of labral preservation research.