Acetabular Labral Reconstruction With Autologous Tendon Tissue in a Porcine Model

Shi, Yuanyuan; Chen, Linxin; Xu, Yan; Hu, Xiaoqing; Ao, Yingfang; Wang, Jianquan

doi:10.1177/0363546515623784

Cited by 25 publications

(16 citation statements)

References 21 publications

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“…A study by Ejnisman et al (36) reported that revision arthroscopies to treat adhesions and residual chondral lesions following labral reconstructions demonstrated graft incorporation and maintenance of the suction seal. This corroborates the findings of Shi et al (37) who reported fully filled labrum defects in six and partially filled defects in three of nine animals in a porcine model, 24 weeks after reconstruction of the defects with gluteus medius tendon.…”

Section: Discussionsupporting

confidence: 92%

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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Section: Discussionsupporting

confidence: 92%

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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“…Tendon tissue has the same orientation of the type I collagen fiber bundles as the peripheral half of the meniscus, suggesting that it has the potential for meniscus replacement. Our previous study has confirmed that autologous tendon grafts for acetabular labral reconstruction can fully or partially repair labral defects and convert to fibrocartilage-like tissue, indicating the fibrochondrogenic metaplasticity potential of tendon tissue 16 . The middle third of the patellar tendon autografts, fresh-frozen Achilles tendon allografts and Achilles tendon autografts were used in partial or total meniscus reconstruction in previous studies, but tendon graft alone without additional modification were reported not satisfactory in meniscus reconstruction 17 – 20 .…”

Section: Introductionsupporting

confidence: 52%

The potential of using semitendinosus tendon as autograft in rabbit meniscus reconstruction

Meng

et al. 2017

Sci Rep

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Since transplantation of meniscal allograft or artificial menisci is limited by graft sources and a series of adverse events, substitution for meniscus reconstruction still needs to be explored. Natural biomaterials, which can provide a unique 3-D microenvironment, remain a promising alternative for tissue engineering. Among them, autograft is a preferred option for its safety and excellent biocompatibility. In this study, we utilized semitendinosus tendon autograft in meniscus reconstruction to investigate its fibrochondrogenic metaplasticity potential and chondroprotective effect. Tendon-derived stem cells (TDSCs) and synovial-derived mesenchymal stem cells (SMSCs), two most important stem cell sources in our strategy, exhibited excellent viability, distribution, proliferation and fibrochondrogenic differentiation ability in decellularized semitendinosus tendon (DST) scaffolds in vitro. Histologic evaluation of the tendon grafts in vivo suggested endogenous stem cells differentiated into fibrochondrocytes, synthesized proteoglycan, type II collagen and radial type I collagen at 12 weeks and 24 weeks post-surgery. As for elastic modulus and hardness of the grafts, there were no significant differences between native meniscus and regenerated meniscus at 24 weeks. The protection of condylar cartilage from degeneration was significantly better in the reconstruction group comparing to control group. Overall, semitendinosus tendon autograft seems to be a promising substitution in meniscus reconstruction.

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“…Notably, we did not include these groups because previous studies had suggested that those allograft may have poorer mechanical properties and are ineffective at healing the interface of graft-labrum compared with native labrum. 26 A second limitation is our study’s sample size in each group was relatively small. Despite the small sample size, we were able to show some meaningful differences between labral defect versus labral reconstruction in this porcine model.…”

Section: Discussionmentioning

confidence: 95%

The Cartilage Protective Effect of Labrum Reconstruction Using Meniscus Allograft Compared with Labrum Resection in a Porcine Model

Yang

Maimaitimin

et al. 2022

CARTILAGE

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Purpose This study aimed to verify the femoral head cartilage protective effect of labral reconstruction in a porcine model. Methods Twelve pigs (24 hips) were divided into 3 groups: labrum defect group, lateral meniscus (LM) allograft group, and LM allograft wrapped with acellular peritoneum matrix (LM-APM) group before undergoing bilateral hip surgery. The pigs were sacrificed at 12 and 24 weeks postoperatively, while the femoral head cartilage was retrieved and then subjected to imaging measurement, macroscopic observations, and biomechanical and histological assessment. Results Imaging measurement and macroscopic observations revealed that the defect area of the labrum was filled in LM and LM-APM allograft groups after 24 weeks, whereas the labrum defect remained at 24 weeks in the control group. The femoral head cartilage corresponding to the area of labral resection in the labral defect group had worse macroscopic Osteoarthritis Research Society International (OARSI) scores, uneven and discontinuous cartilage on hematoxylin and eosin (H&E) staining and Safranin O staining, decreased histopathology OARSI Osteoarthritis Cartilage Histopathology Assessment System (OOCHAS) scores, and decreased elastic modulus and hardness at 12 and 24 weeks after surgery compared with the meniscus allograft groups. Conclusion This study demonstrated that the LM allograft with or without APM for labral reconstruction had a chondroprotective effect on the femoral head in a porcine model.

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Acetabular Labral Reconstruction With Autologous Tendon Tissue in a Porcine Model

Abstract: Autologous tendon tissue can be considered as a viable option for acetabular labral reconstruction.

Cited by 25 publications

References 21 publications

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

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

The potential of using semitendinosus tendon as autograft in rabbit meniscus reconstruction

The Cartilage Protective Effect of Labrum Reconstruction Using Meniscus Allograft Compared with Labrum Resection in a Porcine Model

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