Arthroscopic Reconstruction of Segmental Defects of the Hip Labrum: Results in 22 Patients With Mean 2-Year Follow-Up

Chandrasekaran, Sivashankar; Darwish, Nader; Close, Mary R.; Lodhia, Parth; Suárez-Ahedo, Carlos; Domb, Benjamin G.

doi:10.1016/j.arthro.2017.03.015

Cited by 46 publications

(45 citation statements)

References 33 publications

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“…We report mean group improvement of 20.6 points in the mHHS, 19.0 points in the HOS-ADL and 32.8 in the HOS-SS for this study group. A review of published outcomes on acetabular labral reconstruction revealed outcomes similar to the results of this study ( Table VII ) [ 16 , 26 , 29–37 ]. Philippon et al.…”

Section: Discussionsupporting

confidence: 79%

“…Our patient population differs from several other labral reconstruction study cohorts in that we report a population with high rates of acetabular microfracture (29%), Tönnis grade 1 (22.6%) and high grade (grades 3–4) acetabular cartilage damage (49%) [ 16 , 26 , 36 , 37 ]. This finding suggests patients with irreparable labral damage requiring labrum reconstruction may be more likely to have high grade cartilage damage, but controlled, comparative studies comparing labral reconstruction with debridement/repair are needed to answer this question.…”

Section: Discussionmentioning

confidence: 87%

“…Paired sample t- tests were used to compare preoperative and postoperative scores. A previous study on subjects undergoing segmental labral reconstruction found HOS-ADL scores improved on average by 19 points [ 26 ]. With standard deviation of the baseline HOS-ADL scores in our patient cohort equal to 20, a power analysis was performed, identifying that a minimum of 11 labral reconstruction subjects would be needed to achieve a statistically significant difference with α < 0.05 and power of 0.8.…”

Section: Methodsmentioning

confidence: 99%

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Arthroscopic labral reconstruction using fascia lata allograft: shuttle technique and minimum two-year results

Carreira

Kruchten²,

Emmons

et al. 2018

Journal of Hip Preservation Surgery

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The purpose of this study was to describe the shuttle technique of acetabular labral reconstruction using allograft fascia lata and report minimum two-year clinical outcomes in a prospective patient cohort. We present a shuttle technique to introduce and fixate the allograft, by which the need to fix the free end of the graft from inside the joint is avoided. Between October 2010 and March 2014, 693 hip arthroscopic surgeries were performed by the senior author. Of these 693 patients, 34 patients underwent a labral reconstruction procedure using allograft fascia lata and the shuttle technique and met inclusion criteria. Outcome measures were collected at minimum two years postoperatively. 91.2% (31) of reconstruction patients were available for follow-up at minimum two years after surgery with 12.9% (4) of these patients converting to total hip arthroplasty at average time 27.9 months post-surgery. For the remaining reconstruction patients, mean mHHS increased from 64.0 preoperatively to 84.6 postoperatively (P = 0.0015), SF-12 Physical from 38.9 to 49.0 (P = 0.0004), SF-12 Mental from 49.5 to 55.6 (P = 0.0095), iHOT-12 from 36.4 to 68.1 (P = 0.0017), HOS-ADL from 62.6 to 81.6 (P = 0.0032) and HOS-SS from 32.9 to 65.7 (P < 0.0001). Arthroscopic acetabular labral reconstruction using fascia lata allograft and a shuttle technique appears to be an effective procedure for the treatment of labral pathology through minimum two-year follow-up. While it is difficult to discern the direct influence of the labral reconstructive procedure given the treatment of often concomitant intra-articular pathology, this patient cohort has fared similarly to other cohorts of labral reconstruction patients. No major adverse events are reported.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Arthroscopic labral reconstruction using fascia lata allograft: shuttle technique and minimum two-year results

Carreira

Kruchten²,

Emmons

et al. 2018

Journal of Hip Preservation Surgery

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“…Favorable short-term and mid-term outcomes have been reported for labral reconstructions. 5,[12][13][14][15] As with reconstruction, augmentation seeks to reestablish the labrum's sealing mechanism, which is critical for appropriate biomechanical function of the hip joint 6,16 (Fig 6D and Video 1).…”

Section: Discussionmentioning

confidence: 99%

Hip Labral Augmentation With Tibialis Anterior Tendon Allograft Using the Knotless Pull-Through Technique

Maldonado

Chen

Lall

et al. 2019

Arthroscopy Techniques

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The importance of the labrum in the biomechanics of the hip joint is well documented. Labral tears are the most common pathology in patients undergoing hip arthroscopy and therefore appropriate labral management is vital. Labral preservation has been advocated as a superior alternative to labral excision in terms of clinical outcomes. While reconstruction of the labrum is recommended for irreparable tears, labral augmentation is a viable alternative for labral function restoration under certain indications. This Technical Note will describe a method for arthroscopic hip labral augmentation using an anterior tibialis tendon allograft and the pull-through technique.

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“…Labral augmentation that preserves healthy native labral fibers results in significantly better outcomes than segmental labral grafting 2 and is associated with significant improvement in patient-reported outcomes and function with a low rate of conversion to total hip arthroplasty. 3 The use of arthroscopic techniques to achieve a labral seal has been shown to significantly improve patient outcomes, 4 and postoperative computed tomography arthrography has shown that the repaired labra are well maintained at a minimum 2-year follow-up. In addition, decreased height and width of the labra do not affect the clinical outcomes.…”

Section: Failure Modementioning

confidence: 99%

Editorial Commentary: Acetabular Labral Repair—Is A Knotless Anchor Better?

Barber

Evanson

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Knotless anchors have an important role in arthroscopic acetabular labral repair. Different anchors show 2 primary failure modes: suture breakage and suture pullout from the anchor ("eyelet failure"). Knotless anchors show minimal displacement at physiological loads and should perform well for arthroscopic labral repair. Surgeons should consider the suture-passing device size and use a device that creates as small of a labral hole as possible. See related article on page 70 K notless suture anchors are commonly used in hip arthroscopy and offer some advantages over anchors that require knot tying. These advantages include their ease of use and quicker insertion time compared with tied knots. Although not clearly documented in the current literature, there are anecdotal reports of adhesions between a retained knot and the adjacent capsule or psoas tendon observed during revision hip arthroscopy. This has led some surgeons to suggest that a knotless suture anchor may decrease the creation of such adhesions.

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Arthroscopic Reconstruction of Segmental Defects of the Hip Labrum: Results in 22 Patients With Mean 2-Year Follow-Up

Cited by 46 publications

References 33 publications

Arthroscopic labral reconstruction using fascia lata allograft: shuttle technique and minimum two-year results

Arthroscopic labral reconstruction using fascia lata allograft: shuttle technique and minimum two-year results

Hip Labral Augmentation With Tibialis Anterior Tendon Allograft Using the Knotless Pull-Through Technique

Editorial Commentary: Acetabular Labral Repair—Is A Knotless Anchor Better?

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