Acetabular labral reconstruction using the indirect head of the rectus femoris tendon significantly improves patient reported outcomes

Amar, Eyal; Sampson, Thomas; Sharfman, Zachary T.; Caplan, Alyssa; Rippel, Noa; Atzmon, Ran; Drexler, Michael; Rath, Ehud

doi:10.1007/s00167-017-4641-4

Cited by 38 publications

(48 citation statements)

References 32 publications

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“…In such instances, the study with the largest patient sample (317 patients) was selected for inclusion. A total of seven studies were included in the final systematic review (15)(16)(17)(18)(19)(20)(21). A cross-reference of bibliographies of the included studies did not yield any additional studies for inclusion.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 7 studies and 402 patients (229 males, 173 females) were included in this systematic review. Three studies were retrospective cohort studies (level of evidence III) (18,19,21) and four studies were retrospective case series (level of evidence IV) (15)(16)(17)20). All patients underwent arthroscopic labral reconstruction with autografts; however, graft choices were variable across studies.…”

Section: Resultsmentioning

confidence: 99%

“…All patients underwent arthroscopic labral reconstruction with autografts; however, graft choices were variable across studies. The grafts utilized included iliotibial band (ITB) in two studies (342 patients) (15,19), indirect head of rectus femoris in three studies (32 patients) (16,17,20), gracilis tendon in one study (8 patients) (18), semitendinosus tendon in one study (12 patients) (21), and capsule tissue in one study (8 patients) (20). All studies had a minimum length of follow-up of 12 months (range, 12-120 months).…”

Section: Resultsmentioning

confidence: 99%

“…Preoperatively, all studies, except one (18), reported lateral center edge angle (LCEA) and alpha-angle measurement with X-rays. Four studies utilized the Tönnis classification ≥2 as a contraindication for the procedure (16,18,19,21), while two studies used a joint space width <2 mm as a contraindication for reconstruction (15,16). Four studies reported the use of magnetic resonance imaging (MRI) or arthrography (MRA) preoperatively to confirm the diagnosis of labral pathology (16,17,19,21).…”

Section: Resultsmentioning

confidence: 99%

“…In addition to repair, reconstruction techniques have also been developed in order to treat patients with significant labral tears or insufficient labral tissue not amenable to repair (10)(11)(12)(13)(14)(15). Outcomes following reconstruction have also demonstrated significant improvements in patient reported pain and function in clinical studies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Mechanistically, reconstruction of the labrum has demonstrated an ability to, at least in part, restore the stability of the suction seal effect as shown in in vitro studies (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Indications and Outcomes for Arthroscopic Hip Labral Reconstruction With Autografts: A Systematic Review

Bessa¹,

Williams

Polce

et al. 2020

Front. Surg.

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Background: The acetabular labrum plays a major role in hip function and stability. The gold standard treatment for labral tears is labral repair, but in cases where tissue is not amenable to repair, reconstruction has been demonstrated to provide superior outcomes compared to debridement. Many types of grafts have been used for reconstruction with good to excellent outcomes. Autograft options include iliotibial band (ITB), semitendinosus, and indirect head of the rectus femoris tendon, while allografts have included fascia lata and gracilis tendon allografts. Questions/Purposes: As allografts are not always readily available and have some inherent disadvantages, the aims of this systematic review were to assess (1) indications for labral reconstruction and (2) summarize outcomes, complications, and reoperation rates after arthroscopic labral reconstruction with autografts. Methods: A systematic review of the literature was performed using six databases (PubMed, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Google Scholar) to identify studies reporting outcomes for arthroscopic labral reconstruction utilizing autografts, with a minimum follow-up of 1 year. Study design, patient demographics, autograft choice, complications, donor site morbidity, reoperation rates, conversion to arthroplasty, and patient reported outcomes were extracted and reported. Results: Seven studies were identified for inclusion with a total of 402 patients (173 females, age range 16-72, follow-up range 12-120 months). The most commonly reported functional outcome score was the modified Harris Hip Score (mHHS), which was reported in six of seven studies. Preoperative mHHS ranged from 56 to 67.3 and improved postoperatively to a range of 81.4-97.8. Conversion to total hip arthroplasty and reoperation rates ranged from 0 to 13.2% and 0 to 11%, respectively. The most common indication for labral reconstruction was an irreparable labrum. Autografts utilized included ITB, hamstring tendons, indirect head of rectus femoris, and capsular tissue. Bessa et al. Arthroscopic Autograft Labral Reconstruction Conclusions: Arthroscopic autograft reconstruction of the acetabular labrum results in significant improvement in the short-and mid-term patient reported outcomes, for properly selected patients presenting with pain and functional limitation in the hip due to an irreparable labral injury.

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