The hip antero-superior labral tear with avulsion of rectus femoris (HALTAR) lesion: does the SLAP equivalent in the hip exist?

Background: The purpose of this report is to describe a new lesion, the Hip Antero-superior Labral Tear with Avulsion of Rectus femoris (HALTAR). This injury may be seen in both adolescent and skeletally mature athletes and shares several characteristics with the Superior Labral tear from Anterior to Posterior (SLAP) lesion in the shoulder. Methods: We present a case example, as well as a detailed anatomic description of the pathological condition. Results: As the rectus femoris crosses two joints it is exposed to substantial forces during muscle contraction. Considering the peri-articular origin of the reflected head at the superior aspect of the acetabular rim, a powerful eccentric contraction of the rectus femoris muscle or traction related to sudden knee flexion may cause an avulsion injury of the rectus femoris as well as a concomitant labral tear. Conclusions: A strain injury of the rectus femoris muscle, which is common in young athletic patients, may cause a concomitant tear of the acetabular labrum. Therefore, we recommend further diagnostic work-up in cases with prolonged hip pain and impaired hip function following an AIIS injury in order to identify any associated peri-and intra-articular damage. In our experience these patients seldom need aggressive surgical management.