Perpendicular drill bit alignment provides a practical guidance to determine the appropriate suture anchor insertion angle during acetabular labral repair

Ismailoglu, Abdulveli; Özdoğmuş, Ömer; Karaman, Muhammed Ilkay; Kayaalp, Asım; Kocaoğlu, Barış

doi:10.1093/jhps/hnab055

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…CT-based preoperative planning has more stable inter- and intra-group consistency, as well as high repeatability and accuracy ( 21 , 22 ). Representative software includes Mimics from Materialize (Belgium) ( 23 ), ZedHip/ZedKnee from LEXI (Japan) ( 21 ), and HipPlan from Symbios (Sweden) ( 24 ). However, all these software programs require manual segmentation of the CT images and are more complex than 2D preoperative planning software.…”

Section: Discussionmentioning

confidence: 99%

A novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) to prevent postoperative leg-length discrepancy for femoral neck fractures in hip arthroplasty

Zhang

Zheng²,

Liu³

et al. 2022

Front. Surg.

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ObjectiveTo determine whether the two lower extremities are of equal length after hip arthroplasty for femoral neck fractures, we developed a novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) in hip arthroplasty.MethodsPatients with femoral neck fractures requiring hip arthroplasty from July 2020 to March 2022 in the orthopedic department of Jinjiang Municipal Hospital, Fujian Province, China were recruited. Hip arthroplasty was performed using the proposed “shoulder-to-shoulder” method of manual positioning based on anatomical mark in 52 patients with femoral neck fractures who met the inclusion criteria. “Shoulder-to-shoulder” was achieved by alignment of the marked femoral “shoulder” and the “shoulder” of prosthesis stem. There were 16 male and 36 female patients, with 27 undergoing total hip arthroplasty (THA) and 25 undergoing hip hemiarthroplasty (HA). The fractures were categorized according to the Garden classification: type II, type III, and type IV in 5, 11, and 36 patients, respectively. The vertical distance from the apex of the medial margin of the femoral trochanter to the tear drop line on both sides which was regarded as the length of both limbs were compared via postoperative imaging, and the apex–shoulder distance on the ipsilateral side measured via postoperative imaging was compared with those measured intraoperatively.ResultsAll patients completed the surgery successfully. The measurement results for the lower extremities after THA were as follows: contralateral group, 43.87 ± 5.59 mm; ipsilateral group, 44.64 ± 5.43 mm. The measurement results for the lower extremities after HA were as follows: contralateral group, 45.18 ± 7.82 mm; ipsilateral group, 45.16 ± 6.43 mm. The measurement results for the lower extremities after all arthroplasties were as follows: contralateral group, 44.50 ± 6.72 mm; ipsilateral group, 44.89 ± 5.90 mm. The results for the apex–shoulder distance were as follows: postoperative imaging, 19.44 ± 3.54 mm; intraoperative apex–shoulder distance, 27.28 ± 2.84 mm. Statistical analysis results indicated no statistically significant difference in the postoperative bilateral lower extremity length after hip arthroplasty (P = 0.75), while a statistically significant difference was found between the intraoperative and postoperative imaging measurements of the apex–shoulder distance (P < 0.01).ConclusionThe novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) for femoral neck fractures in hip arthroplasty is simple and accurate, making it effective for preventing postoperative bilateral leg length discrepancy.

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Section: Discussionmentioning

confidence: 99%

A novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) to prevent postoperative leg-length discrepancy for femoral neck fractures in hip arthroplasty

Zhang

Zheng²,

Liu³

et al. 2022

Front. Surg.

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“…The AAD (θ) is the angle between the actual direction ( d a ) and the ideal direction ( d i ) of the anchor perpendicular to the acetabular opening plane. 13 It was computed from the vector of orientations in the x , y , and z planes:…”

Section: Methodsmentioning

confidence: 99%

Portal Selection for Suture Anchor Placement During Hip Arthroscopic Labral Repair: A Study Based on 3-Dimensional Model Reconstruction

Chen,

Zou,

Wang

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Arthroscopic suture repair is the main treatment option for hip labral tears; however, anchor insertion and placement from arthroscopic portals is difficult. Purpose: To quantitatively evaluate the safety of various arthroscopic portals for suture anchor placement during hip labral repair. Study Design: Descriptive laboratory study. Methods: The computed tomography scans of 20 patients with normally developed hip joints were used to create 3-dimensional models. The distances from the anchor to the articular cartilage (DAC) and from the acetabular insertion point to the cortical bone (DCB) were measured in the anterolateral portal (AL), posterolateral portal (PL), midanterior portal (MAP), medial MAP, and 3 distal anterolateral accessory portals (DALAs): DALA-proximal, DALA-middle, and DALA-distal. Labral tears were divided into anterior (4, 3, and 2 o’clock), lateral (1, 12, and 11 o’clock), and posterior (10, 9, and 8 o’clock) acetabular zones, and the Kruskal-Wallis and Mann-Whitney U test were used to compare DAC and DCB in the zones. The success rate was defined as anchors placed with DAC ≥1 mm and DCB ≥15 mm. Results: The DAC was significantly smaller in the AL at 1 o’clock (0.68 ± 0.32 mm; P < .001) and 12 o’clock (0.37 ± 0.30 mm; P < .001), and in the PL at 12 o’clock (-0.35 ± 0.38 mm; P < .001) and 11 o’clock (0.60 ± 0.24 mm; P < .001). The DCB was significantly smaller in the DALA-P at 3 o’clock (8.93 ± 2.12 mm; P < .001) and 11 o’clock (9.59 ± 2.84 mm; P < .001), the MAP at 12 o’clock (13.76 ± 3.89 mm; P < .001) and 11 o’clock (0.27 ± 0.27 mm; P < .001), and the MMA at 12 o’clock (5.96 ± 2.31 mm; P < .001) and 11 o’clock (0 mm; P < .001). Success rates were high for MAP and MMA between 4 o’clock and 1 o’clock, for DALA-proximal at 12 o’clock, for AL at 11 o’clock, and for PL between 10 o’clock and 8-o’clock. Conclusion: There were significant differences in the success rate of anchor placement using different portals during hip arthroscopic labral repair. Clinical Relevance: MAP is recommended for labral repair between 4 o’clock and 1 o’clock, DALA-P is recommended between 2 o’clock and 12 o’clock, AL is suitable at 11 o’clock, and PL is suitable between 10 o’clock and 8 o’clock.

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Comparison of Knotless Versus Knot-Tying Suture Anchors for Arthroscopic Repair of Hip Labral Tears

Celiksoz,

Bayram,

Yozgatli

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: Both knotless and knot-tying anchors are commonly employed in the arthroscopic repair of hip labral tears. Purpose: To compare the midterm clinical results of arthroscopic hip labral repair using knot-tying versus knotless suture anchors. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent arthroscopic hip labral repair between January 2017 and January 2021 and who had at least 2 years of follow-up were included. The patients were divided into 2 groups based on the suture anchor type: a 2.9-mm knotless suture anchor (knotless group) or a 1.8-mm knot-tying suture anchor (knot-tying group). All patients underwent femoroplasty for cam lesions and acetabular rim trimming for pincer lesions. The modified Harris Hip Score (mHHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), 12-item International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain were administered both preoperatively and postoperatively. The consistency of the outcome scores was assessed using the minimal clinically important difference and Patient Acceptable Symptom State. The statistical significance between groups was evaluated using the Mann-Whitney test and quantile-based analysis of variance. Results: A total of 413 patients were included: 256 patients in the knotless group (median age, 35 years [interquartile range, 31-38 years]; median follow-up, 34 months) and 157 patients in the knot-tying group (median age, 34 years [interquartile range, 30-38 years]; median follow-up, 25 months). There were no significant differences in postoperative mHHS, HOS-ADL, or iHOT-12 scores between the 2 groups. However, there were significant differences, favoring the knotless group over the knot-tying group, in postoperative HOS-SSS (87 ± 2 vs 86 ± 1, respectively) and VAS pain (1 vs 2, respectively) scores ( P < .0001 for both). Postoperative synovitis was found in significantly more patients in the knot-tying group than in the knotless group (17 vs 5, respectively; P = .01). Conclusion: In this study, patients who underwent arthroscopic hip labral repair with knotless suture anchors had slightly better postoperative HOS-SSS and VAS pain scores and a lower incidence of postoperative synovitis compared with patients who underwent repair with knot-tying suture anchors.

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Perpendicular drill bit alignment provides a practical guidance to determine the appropriate suture anchor insertion angle during acetabular labral repair

Cited by 3 publications

References 24 publications

A novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) to prevent postoperative leg-length discrepancy for femoral neck fractures in hip arthroplasty

A novel method of manual positioning based on anatomical mark (shoulder-to-shoulder) to prevent postoperative leg-length discrepancy for femoral neck fractures in hip arthroplasty

Portal Selection for Suture Anchor Placement During Hip Arthroscopic Labral Repair: A Study Based on 3-Dimensional Model Reconstruction

Comparison of Knotless Versus Knot-Tying Suture Anchors for Arthroscopic Repair of Hip Labral Tears

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