Arthroscopic Treatment of Symptomatic Paralabral Cysts in the Hip

Acetabular labral tears or paralabral cysts in the hip are frequently detected using magnetic resonance imaging or arthrography. Unlike parameniscal cysts in the knee and paralabral cysts in the shoulder, reports of the outcomes of surgical treatment for paralabral cysts in the hip recalcitrant to conservative management are limited in the literature. The authors report 2 cases of paralabral cysts in the hip that were treated with arthroscopic surgery. The patients presented with chronic hip pain, and preoperative magnetic resonance imaging showed paralabral cysts at the superior aspect of the acetabulum. After failure of conservative management for more than 6 months, arthroscopic surgery was performed while the patients were under general anesthesia and in a supine position on a fracture table. Arthroscopic examination confirmed the preoperative diagnosis of paralabral cysts with degenerative labral fibrillation or tears in both patients. Arthroscopic cyst decompression and debridement of the degenerative labral tissues were performed using an arthroscopic thermal probe and a shaver. Clinical outcomes, determined by the Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index score, and University of California, Los Angeles activity score, were satisfactory for the 2 patients at 2 and 3 years postoperatively, respectively. Magnetic resonance imaging obtained for 1 patient at 6 months postoperatively showed complete decompression of the paralabral cyst. The authors believe that arthroscopic treatment for symptomatic hip paralabral cysts is a safe and effective procedure with excellent clinical outcomes.