Arthroscopic Labral Repair of the Hip Using a Self-Grasping Suture-Passing Device: Maintaining the Chondrolabral Junction

Abstract

In the setting of femoroacetabular impingement, the acetabular labrum may be torn or pathologic, and it must be surgically repaired to restore the native suction seal and hip function. However, the current methods of arthroscopic suture passage commonly result in some degree of disruption of the chondrolabral junction, with penetration and shuttling of the repair sutures. Novel instrumentation and surgical techniques have aimed to repair the acetabular labrum with decreased violation of the intrasubstance fibers to provide anatomic eversion/inversion of the labrum to restore the suction seal. In this Technical Note, we describe a method of suture passage through the use of a self-grasping suturepassing device that allows for anatomic labral repair while maintaining the chondrolabral junction as well as minimizing iatrogenic damage the labrum intrasubstance fibers.

Arthroscopic Treatment of Femoral Neck Impingement Cysts Using Biocomposite Anchors in the Setting of Femoroacetabular Impingement

“…Full cam decompression and confirmation with intraoperative dynamic examination are performed as described in previous technical notes. 8 Complete contouring of the biocomposite anchor is again confirmed prior to closure of the capsule.…”

“…After standard hip arthroscopy setup and patient positioning is established, standard anterolateral and midanterior portals are placed, which has been described by our team previously. 8…”

“…After standard hip arthroscopy setup and patient positioning is established, standard anterolateral and midanterior portals are placed, which has been described by our team previously. 8 After intraoperative assessment, the central compartment is addressed first. The acetabular rim is exposed and acetabuloplasty is performed with a curved 4.5-mm burr for suture bed prep, as demonstrated here.…”

Effect of Anchor Density on Functional Outcomes After Arthroscopic Hip Labral Repair

“…using a previously described technique. 30,36 Briefly, standard anterolateral and midanterior portals were established, and diagnostic arthroscopic surgery was performed to identify labral abnormalities and assess tissue quality. After preparation of the repair site, the initial anchor was placed at the most anterior aspect of the tear.…”

“…Hip arthroscopic surgery has evolved over time with a better understanding of labral repair techniques and significant advances in maintaining the suction seal, minimizing adhesions, and maximizing patient outcomes. 1,13,31,36,40,42 Suture anchors of varying types, including different sizes, different materials, knotted versus knotless, and different methods of passing sutures, are available to surgeons and are the mainstay for labral fixation. 4,7,9,11,14,38 Despite several variations of anchors, anchor utilization is of critical importance, as improper use (ie, position, size, location, etc) may lead to complications such as repair failure, chondral damage, or disruption of the medial pelvic wall.…”