Our population is aging, and the most rapid shift in this age distribution is set to occur as the baby boomers reach their senior years. In the United States alone, the Centers for Disease Control and Prevention estimate that approximately 70 million Americans suffer from arthritis or chronic joint ailments, and, according to the American Academy of Orthopaedic Surgeons, approximately 300,000 hip arthroplasties are performed annually.15,16 Even in absence of arthritis, the hip joint is known to undergo senile changes. An MRI study has demonstrated an increasing incidence of labral pathology with age, even among asymptomatic volunteers.17 An electron microscopy study had documented degenerative labral changes associated with the aging process, and this is consistent with two separate cadaveric studies that showed a 96% preva-
FIGURE 15.1. A 14-year-old girl with acute locking and catching of the right hip. (A) Anteroposterior radiograph demonstrates evidence of residual developmental dysplasia of the hip (DDH) of both hips and changes consistent with multiple previous osteotomies. Slight lateral joint space narrowing of the right hip is seen compared with the left. (B) Arthroscopic view from the anterolateral portal demonstrates an unstable entrapped anterior labrum (asterisk). (C) Debridement of the unstable portion of the
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