Investigation of the Preservation of the Fluid Seal Effect in the Repaired, Partially Resected, and Reconstructed Acetabular Labrum in a Cadaveric Hip Model

Cadet, Edwin R.; Chan, Andrew K.; Vorys, George C.; Gardner, Thomas R.; Yin, Bob

doi:10.1177/0363546512457645

Cited by 116 publications

(88 citation statements)

References 23 publications

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“…This study reported that the native labrum and labral repair provided a better seal (less fluid efflux) than the labral tear, partial resection, and labral resection conditions [32]. The native labrum, however, still provided a better seal than labral repair, and interestingly, labral reconstruction was similar to the labral tear and partial resection conditions with regards to maintaining the labral sealing function [32]. Labral reconstruction can be performed in the labrum deficient state as seen in the setting of global acetabular overcoverage with rim ossification and prior labral resection.…”

Section: The Acetabular Labrummentioning

confidence: 85%

“…They noted better outcomes with labral repair for the ADL and Sports subscale of the Hip Outcomes Score at a mean 32 months follow-up [31]. A recent study looked at the sealing function (fluid efflux) of the native labrum, labral tear, labral repair, partially resected labrum, and labral reconstruction in a cadaveric model [32]. This study reported that the native labrum and labral repair provided a better seal (less fluid efflux) than the labral tear, partial resection, and labral resection conditions [32].…”

Section: The Acetabular Labrummentioning

confidence: 99%

“…A recent study looked at the sealing function (fluid efflux) of the native labrum, labral tear, labral repair, partially resected labrum, and labral reconstruction in a cadaveric model [32]. This study reported that the native labrum and labral repair provided a better seal (less fluid efflux) than the labral tear, partial resection, and labral resection conditions [32]. The native labrum, however, still provided a better seal than labral repair, and interestingly, labral reconstruction was similar to the labral tear and partial resection conditions with regards to maintaining the labral sealing function [32].…”

Section: The Acetabular Labrummentioning

confidence: 99%

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Current concepts and trends for operative treatment of FAI: hip arthroscopy

Larson

Stone

2013

Curr Rev Musculoskelet Med

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There has been an increasing body of literature regarding arthroscopic management of femoroacetabular impingement (FAI). Refinement of arthroscopic techniques has allowed for more complete management of FAI, and metaanalysis and systematic reviews have shown comparable outcomes to surgical hip dislocation with appropriate indications. There are still, however, pathomorphologies that are not accessible or much more challenging to address arthroscopically, and open corrective procedures should be considered in these situations. Extra-articular FAI is receiving increased attention and can be secondary to anterior inferior iliac spine/subspine impingement, trochanteric-pelvic impingement, and ischiofemoral impingement. Femoral and acetabular version and their impact on hip stability as well as the concept of impingement induced instability are being increasingly recognized. Acetabular labral and capsular management and repair techniques have also received increased attention. Finally, 3-dimensional imaging and dynamic software analysis are beginning to emerge as potential tools to better evaluate hip pathomorphology.

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Section: The Acetabular Labrummentioning

confidence: 85%

Section: The Acetabular Labrummentioning

confidence: 99%

Section: The Acetabular Labrummentioning

confidence: 99%

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Current concepts and trends for operative treatment of FAI: hip arthroscopy

Larson

Stone

2013

Curr Rev Musculoskelet Med

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“…Until recently, the surgical treatment of choice was resection of the unstable segment, although excision is eventually followed by an unsatisfactory outcome in onethird of reported cases [13,50]. Experimental evidence suggests that the normal labrum plays a role in joint force distribution, stability, or lubrication [15,19,23,24,27,30,33,44] and that loss of this function will predispose subjects to chondral damage even when underlying deformities are corrected.…”

Section: Introductionmentioning

confidence: 99%

No Regeneration of the Human Acetabular Labrum After Excision to Bone

Miozzari

Celia

Clark

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Treatment options for a symptomatic, torn, irreparable, or completely ossified acetabular labrum are limited to either excision and/or reconstruction with grafts. In a previous animal model, regeneration of the acetabular labrum after excision to the bony rim has been shown. In humans, less is known about the potential of regeneration of the labrum. Recent studies seem to confirm labral regrowth, but it is still unclear if wide excision might be a surgical option in cases where repair is not possible.Questions/purposes The purposes of this study were (1) to determine the extent of acetabular labrum regeneration after excision to the bony rim; and (2) to determine whether this procedure results in higher hip scores. Methods We reviewed all patients treated with surgical dislocation for symptomatic femoroacetabular impingement by a single surgeon at one institution between 2003 and 2008, of whom 14 underwent wide labral excision (of at least 60°) down to bone; we used this approach when there was an absence of reparable tissue. Of these 14, nine were available for voluntary reexamination. The mean age at surgery was 38 ± 9 SD years and the mean followup was 4 ± 1 SD years. All patients consented to a physical examination and an MRI arthrogram, which was evaluated for evidence of new tissue formation by four observers. A modified Harris hip score and the UCLA were recorded.

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“…2 Cadaveric studies have proposed that the hip labrum provides a "fluid seal effect." 3 By providing a fluid seal, the labrum is thought to prevent loss of synovial fluid from the central compartment, thereby protecting the articular cartilage and minimizing the risk of osteoarthritis. Given the biomechanical properties of the hip labrum, labral preservation and reconstruction are preferred over partial labral resection for the treatment of acetabular labral tears, regardless of the presence of femoroacetabular impingement.…”

mentioning

confidence: 99%

All-Arthroscopic Reconstruction of the Acetabular Labrum by Capsular Augmentation

Nwachukwu

Alpaugh

McCormick

et al. 2015

Arthroscopy Techniques

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The acetabular labrum plays an important role in hip joint stability and articular cartilage maintenance. As such, reconstitution of the labral complex is ideal. In cases in which the labrum is too degenerative to allow adequate reconstruction with current repair techniques, a capsular augmentation is a novel technique that can be used to restore the labral structure. Use of capsular augmentation enables preservation of the donor-tissue blood supply with local tissue transfer, without adding significant complexity to the procedure or significant donor-site morbidity.

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Investigation of the Preservation of the Fluid Seal Effect in the Repaired, Partially Resected, and Reconstructed Acetabular Labrum in a Cadaveric Hip Model

Abstract: Further prospective studies are needed to determine whether hip labral repair outperforms partial labral resection and/or reconstruction in clinical practice.

Cited by 116 publications

References 23 publications

Current concepts and trends for operative treatment of FAI: hip arthroscopy

Current concepts and trends for operative treatment of FAI: hip arthroscopy

No Regeneration of the Human Acetabular Labrum After Excision to Bone

All-Arthroscopic Reconstruction of the Acetabular Labrum by Capsular Augmentation

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