Arthroscopic Acetabular Labral Reconstruction with Fascia Lata Allograft: Clinical Outcomes at Minimum One-Year Follow-Up

Rathi, Ritesh; Mazek, Jacek

doi:10.2174/1874325001611010554

Cited by 16 publications

(17 citation statements)

References 23 publications

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“…The postoperative mHHS for each study is shown in Figure 2. Additionally, 6 studies (2 allograft 3,25 and 4 autograft 1,7,14,24 ) provided sufficient data to conduct a meta-analysis comparing pre- versus postoperative mHHS scores (Figure 3). The random effects pooled mean difference in the mHHS, based on these 6 studies and a total of 315 patients, was an improvement of 29.0 points (95% CI, 20.2-37.8; P < .0001).…”

Section: Resultsmentioning

confidence: 99%

Outcomes After Arthroscopic Hip Labral Reconstruction: A Systematic Review and Meta-analysis

et al. 2019

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Background: The acetabular labrum is critical to maintenance of hip stability and has been found to play a key role in preservation of the hip fluid seal. For irreparable labral damage, arthroscopic labral reconstruction is an evolving technique that has been shown to decrease hip pain and restore function. Purpose: To provide a comprehensive review of current literature for arthroscopic hip labral reconstruction, with a focus on determining if outcomes differ between autograft or allograft tissue. Study Design: Systematic review and meta-analysis. Methods: PubMed and Scopus online databases were searched with the key terms “hip,”“labrum,”“reconstruction,” and “graft” in varying combinations. Procedures performed, complications, failures, and functional outcome measures were included in this analysis. The inverse variance method was used to calculate pooled estimates and 95% CIs. Results: Eight studies with 537 hips were included. Mean age was 37.4 years (95% CI, 34.5-40.4 years), and mean follow-up time was 29 months (95% CI, 26-33 months). Survivorship after autograft reconstruction ranged from 75.7% to 100%, as compared with 86.3% to 90.0% in the allograft cohort. In the autograft cohort, failures included 0% to 13.2% conversion to total hip arthroplasty and 0% to 11.0% revision hip arthroscopy. Failures in the allograft cohort included 0% to 12.9% total hip arthroplasty conversion, 0% to 10.0% revision arthroscopy, and 0% to 0.8% open revision surgery. Based on 6 studies, the modified Harris Hip Score improved by a mean 29.0 points after labral reconstruction ( P < .0001). Conclusion: Arthroscopic hip labral reconstruction results in clinically significant improvements in patient-reported outcomes. Our analysis indicates that there are no significant differences in outcomes based on graft type alone. A number of factors may determine graft choice, including patient preference, surgeon experience, operative time, morbidity, and cost. Proper patient selection based on age and severity of degenerative joint disease will also optimize outcomes after labral reconstruction.

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Section: Resultsmentioning

confidence: 99%

Outcomes After Arthroscopic Hip Labral Reconstruction: A Systematic Review and Meta-analysis

et al. 2019

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“…Six meta-analysis or systematic reviews have been published in the last few years, alone, and point to equivalent or improved results with labral reconstruction compared to repair (Table 1) [7][8][9]11,17,18]. Likewise, at least 17 studies have been published within the last decade evaluating various outcomes of arthroscopic labral reconstruction using allograft [4,5,9,10,[12][13][14]16,[19][20][21][22][23][24][25][26][27] and autograft [28][29][30][31][32][33][34][35][36] techniques (Table 2). Overall, current evidence has concluded that arthroscopic labral reconstruction of the hip is associated with improved pain and functional status, low rates of complications or need for revision surgery, and rare progression of arthritis.…”

Section: Historical Perspectivesmentioning

confidence: 99%

Allograft Labral Reconstruction of the Hip: Expanding Evidence Supporting Greater Utilization in Hip Arthroscopy

White

Constantinides²

2022

Curr Rev Musculoskelet Med

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Purpose of Review The current review investigates outcomes and failure rates associated with arthroscopic circumferential allograft labral reconstruction of the hip, both as a revision and primary procedure in treating femoroacetabular hip impingement and labral-related pathology. Recent Findings Numerous studies within the last decade have demonstrated excellent patient-reported outcomes, high rates of return-to-play in athletes, and low failure rates in patients having undergone arthroscopic circumferential allograft labral reconstruction of the hip. Removal of chronically diseased and injured labral tissue can eliminate a significant pain-generator from the hip joint. Additionally, circumferential reconstruction of the labrum restores the hoop fiber strength and fluid seal akin to what would be seen with native, healthy labral tissue. Recent research has shown that arthroscopic circumferential allograft labral reconstruction may be used not only in the revision setting, but as a primary procedure. Circumferential labral reconstruction should be considered when a surgeon feels that the labrum is irreparable or has failed previous repair. Summary Arthroscopic circumferential allograft labral reconstruction of the hip can be utilized as treatment option not only in revision settings, but also in primary treatment for femoroacetabular impingement and labral pathology

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“…Labral reconstruction using the tensor fascia lata was described by Rathi and Mazek [14] in 2017. The benefit of this graft choice is the versatility of the graft in terms of adjusting the grafts diameter (Fig.…”

Section: Tensor Fascia Lata Allograftmentioning

confidence: 99%

“…Anchors are used to secure the graft to the acetabular rim, taking care to avoid gaps between the native labrum and the graft. Rathi and Mazek [14] reported mHHS improvements from 58 (55–60) preoperatively to 95 (91–98) postoperatively at mean follow-up of 23 months (range: 16–36 months).…”

Section: Tensor Fascia Lata Allograftmentioning

confidence: 99%

Graft choices for acetabular labral reconstruction

Atzmon

Radparvar

Sharfman

et al. 2018

Journal of Hip Preservation Surgery

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The acetabular labrum plays a key role in maintaining hip function and minimizing hip degeneration. Once thought to be a rare pathology, advances in imaging have led to an increase in the number of diagnosed labral tears. While still a relatively new field, labral reconstruction surgery is an option for tears that are irreparable or require revision after primary repair. Various autograft and allograft options exist when considering labral reconstruction. The first labral reconstruction surgery was described using the ligamentum teres capitis, and has since evolved, incorporating more graft sources and reconstructive techniques. The purpose of this review is to assess and describe the different graft sources and technique currently implemented by hip surgeons. Moreover, this review attempts to determine whether a single labral reconstructive graft type is superior to the others. Techniques using the Ligamentum teres capitis autograft, ITB autograft, gracilis autograft, quadriceps tendon autograft, capsular autograft, semitendinosus allograft, indirect head of the rectus femoris autograft, peroneus brevis tendon allograft and Tensor fascia lata allograft were found. Scoring was available on 5 out of the 9 graft types. The advantages and disadvantages of each graft source is described as a comparative tool. No single graft type has shown increased benefit in acetabular labral reconstruction. The lack of uniform outcome measurements hinders comparison of reported outcomes. Surgeons should make an informed decision based on their experience as well as the patient’s history and needs when choosing which graft type would be best suited for their patients.

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Arthroscopic Acetabular Labral Reconstruction with Fascia Lata Allograft: Clinical Outcomes at Minimum One-Year Follow-Up

Abstract: Abstract:Background:

Cited by 16 publications

References 23 publications

Outcomes After Arthroscopic Hip Labral Reconstruction: A Systematic Review and Meta-analysis

Outcomes After Arthroscopic Hip Labral Reconstruction: A Systematic Review and Meta-analysis

Allograft Labral Reconstruction of the Hip: Expanding Evidence Supporting Greater Utilization in Hip Arthroscopy

Graft choices for acetabular labral reconstruction

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