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MSK 2 (F22) > Labrum > Flashcards

Labrum Flashcards

1
Q

Labrum ring is completed by ___

A

Transverse Lig

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2
Q

Anterior half collagen

A

Thin
Parallel fibers

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3
Q

Posterior half collagen

A

Thick
Perpendicular fibers

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4
Q

Vascularization

A

outer 3rd

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5
Q

Functions of labrum

A

Increase joint depth
Stabilize
Increase congruency
Protect articular cartiliage

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6
Q

How are labral tears classified?

A

Directional: A vs P
Physical Location: at articular cartilage vs within substance

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7
Q

Labral tear at articular cartilage

A

Labrum detaches from articular surface.
Advanced tear = cartilage detaches from bone.

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8
Q

Labral tear within substance

A

Perpendicular thru the plane of the labrum

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9
Q

Risk factors for labrum tear

A

FAI
Trauma
Hypermobility/laxity
DDH
Degeneration

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10
Q

What types of trauma increase risk of labrum tear?

A

Femoral head dislocation or subluxation

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11
Q

Hypermobility & capsular laxity can result from what?

A

Underlying disorders, hormone influences.
Abnormal loading in ER - kicking/twisting sports.

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12
Q

What is FAI?

A

Compression of anterior-superior labrum.
Compressed btwn acetabulum & anterior femoral neck.

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13
Q

Causes of FAI

A

Congenital
Acquired from sport

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14
Q

CAM FAI

A

Most common type of FAI.
Bony overgrowth of femoral neck.
Direct impingement of femoral head on labrum = shear force btwn labrum & articular cartilage.

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15
Q

Pincer FAI

A

Overhang of anterior-superior rim of acetabulum

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16
Q

Isolated traumatic MOI

A

HyperABD
Twisting
Falling
MVA
Dislocation

17
Q

Repetitive microtrauma MOI

A

Sports involving ER and hyperext (hockey, soccer, ballet, golf)

18
Q

Symptoms

A

C Sign
Clicking, catching, instability.
Pain: groin & anterior hip. Constant dull w/ episodes of sharp.
Aggs: sitting, STS, descending stairs.
Night pain: lying on affected side, or innominate rotation.

19
Q

Functional limitations

A

Antalgic gait
Stairs
Sitting or walking for extended time
Pivoting/rotation activities
Impact (running, jumping)

20
Q

Gait

A

Prolonged foot flattening
Decreased knee flex at heel strike
Hip hyperext & ER

21
Q

Posture

A

Swayback or Lower Crossed

22
Q

ROM

A

Limited ER/IR, flexion, add/ABD.
Pain at end-range FADIR.
Pain moving from flex to ext.

23
Q

MMT

A

Weak flexion & adduction

24
Q

Pt education: avoid what activities?

A

Crossing legs
Pelvic rotation during STS
Hyperextension during gait or exercise
High impact exercise

25
Q

Optimize biomechanical alignment by controlling…

A

Force from glutes (ext).
Force from iliopsoas (flex).

26
Q

Other PT treatment options

A

PNF
Aquatics (once wounds healed if post-op)

27
Q

Indications for surgery

A

FAI
Conservative tx not improving s/s

28
Q

Contraindications for surgery

A

Significant OA
Uncorrected DDH
Asymptomatic

29
Q

Potential complications during surgery

A

Traction-related injury
Portal placement
Chondral/labral damage
Instability
Inadequate correction of FAI

30
Q

Potential complications post-op

A

Excess fluid
Femoral neck fx
AVN
HO

31
Q

Surgical procedure options

A

Debridement
Repair
Reconstruction

32
Q

Debridement

A

Arthroscopic
Part of labrum removed.
Good for immediate relief but worst long-term outcomes.
Increased risk of OA (like meniscectomy).

33
Q

Repair

A

Arthroscopic
Performed if labral tissue is adequate.
Better outcomes, prevents degeneration & maintains stability.
Looped Repair (for small) or Labral Base Re-Fixation (for large).

34
Q

Reconstruction

A

Open or Arthroscopic
Performed if repair too difficult or previous debridement cannot be repaired.
Graft from ITB, Ligamentum Teres Capitis, Gracilis.

35
Q

Reconstruction: allograft vs autograft, which has better outcomes?

A

Allograft - less prone to fraying/swelling.

36
Q

Reconstruction: open vs arthroscopic, which has better outcomes?

A

Arthro - less scar, less risk of infect, less post-op pain.

MSK 2 (F22) (17 decks)

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