Arthroscopic Labralization of the Hip: An Alternative to Labral Reconstruction

Matsuda, Dean K.

doi:10.1016/j.eats.2013.09.009

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…In labral reconstruction we overlap our terminal anchor sites with stable labral margins; the most posterior anchor site is often located in this far-posterior zone. We have also used arthroscopic labralization 21 to restore the labral fluid seal function when severe labral insufficiency remains after global acetabuloplasty; this technique has been particularly helpful in cases of farposterior labral insufficiency.…”

Section: Technical Notementioning

confidence: 99%

Hip Arthroscopy for Challenging Deformities: Global Pincer Femoroacetabular Impingement

Matsuda

Gupta

Hanami

2014

Arthroscopy Techniques

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Pincer femoroacetabular impingement occurs in focal or global forms, the latter having more generalized and typically more extreme acetabular overcoverage. Severe global deformities are often treated with open surgical dislocation of the hip. Arthroscopic technical challenges relate to difficulties with hip distraction; central-compartment access; and instrument navigation, acetabuloplasty, and chondrolabral surgery of the posterior acetabulum. Techniques addressing these challenges are introduced permitting dual-portal hip arthroscopy with central-compartment access, subtotal acetabuloplasty, and circumferential chondrolabral surgery. The modified midanterior portal in combination with a zonespecific sequence of acetabular rim reduction monitored with fluoroscopic templating enables precision subtotal acetabuloplasty. Guidelines for acetabular rim reduction include the following suggested radiographic endpoints: postoperative center-edge angle of 35 , a neutral posterior wall sign, and an anterior margin ratio of 0.5. Arthroscopic zone-specific chondrophobic rim preparation and circumferential labral reparative and reconstructive techniques and tools permit the arthroscopic treatment of these challenging deformities.

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Section: Technical Notementioning

confidence: 99%

Hip Arthroscopy for Challenging Deformities: Global Pincer Femoroacetabular Impingement

Matsuda

Gupta

Hanami

2014

Arthroscopy Techniques

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“…26,27 The patient satisfaction rate was high (4 highly satisfied, 2 satisfied). 26,27 The patient satisfaction rate was high (4 highly satisfied, 2 satisfied).…”

Section: Discussionmentioning

confidence: 99%

“…26,27 A burr (Flat-top; Smith and Nephew, Andover, MA) may be used to optimize rim trimming while preserving labrum and articular cartilage (Fig. 14, 15).…”

Section: Arthroscopic Labralizationmentioning

confidence: 99%

Arthroscopic Hip Labral Reconstruction

Matsuda¹

2012

Techniques in Orthopaedics

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The acetabular labrum seems to have a role in hip preservation. Reparative techniques to preserve this structure are in common use. However, in some instances, severe labral insufficiency in terms of quantity and/or quality may prevent successful labral preservation. In select patients, arthroscopic labral reconstruction may be performed. Autografts include the iliotibial band, the gracilis (or semitendinosis) tendon, and the reflected head of the rectus femoris. These techniques are presented and contrasted with a focus on key surgical steps. Arthroscopic labralization is introduced as a potential alternative technique to labral reconstruction. Encouraging outcomes from these innovative procedures are emerging, which support the theoretical concept of labral grafting in the hip.

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“…In patients not suitable for labral reconstruction, Matsuda described a novel technique called "labralization. " [22] This technique can be quickly performed by selectively burring the acetabular rim resulting in undermining of the acetabular articular cartilage. The resultant free acetabular cartilage acts as a "pseudolabrum" providing immediate fluid seal restoration.…”

Section: Labral Repair and Reconstructionmentioning

confidence: 99%

Recent advances and future trends in hip arthroscopy

Zhang

Pettit

Kumar

et al. 2020

JASSM

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Hip arthroscopy (HA) is a well-established minimally invasive technique used to treat a wide range of conditions. Technological innovations have expanded the scope of HA and improved its outcomes. Several authors have described post-less arthroscopy to overcome the risk associated with the use of the perineal post for obtaining distraction of the hip joint. Instrument refinement has improved the efficacy of labral repair and reconstruction. Several treatment strategies are available for articular cartilage defects including ACI, MACI, and mosaicplasty, to name a few. Some authors have suggested that ligamentum teres reconstruction is helpful in young active patients with femoroacetabular impingement experiencing subluxation of the hip joint. The incorporation of new technology and patient-specific approaches represents a new way to improve HA outcomes. Virtual reality simulation training is the key to overcoming the steep learning curve associated with HA and to achieve high standards early in a surgeon’s career. Computer-based navigation surgery may be the key to accurately resecting the cam deformity and reducing the rate of revision surgery due to inaccurate resection at the index procedure. Assessment and optimization of the baseline psychological state and effective pre-habilitation may also improve outcome measures. Adequate stratification of the pathology and assessment of baseline patient characteristics influences the long-term outcome following the HA.

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Arthroscopic Labralization of the Hip: An Alternative to Labral Reconstruction

Cited by 3 publications

References 17 publications

Hip Arthroscopy for Challenging Deformities: Global Pincer Femoroacetabular Impingement

Hip Arthroscopy for Challenging Deformities: Global Pincer Femoroacetabular Impingement

Arthroscopic Hip Labral Reconstruction

Recent advances and future trends in hip arthroscopy

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