Posterolateral Acetabuloplasty and Distal Femoral Neckplasty, Labral Repair, and Capsular Plication for Hip Reverse Contre-Coupe Lesion

Abstract

This article describes the arthroscopic approach and management of a “reverse contre-coup” injury to the hip labrum. The injury occurs in the setting of posterolateral acetabular rim over-coverage impinging on the distal femoral neck in extension causing the femoral head to lever out anteriorly against the labrum. Ligamentous laxity and associated loss of anterior capsular restraint allow increased femoral head translation, adding further insult to the anterior labrum. The arthroscopic approach entails not only a labral repair with correction of the osseous conflict but also restoration of soft-tissue stability to minimize anterior femoral translation.