Circumferential Labral Reconstruction Using the Knotless Pull-Through Technique—Surgical Technique

Abstract

Arthroscopic labral reconstruction is an alternative procedure for an irreparable hip labrum in the nonarthritic hip population. Although labral reconstruction is a relatively new procedure, data in the literature show favorable outcomes. Patients have shown beneficial outcomes from labral reconstructive surgery as well as when compared with labral repair and debridement patients. However, one of the challenges in performing labral reconstruction has been correctly measuring the graft to perfectly fit the area of labral deficiency. We propose a labral reconstruction technique that will eliminate inaccuracies in graft measurement while incorporating beneficial characteristics of the knotless suture. The advantages of this technique will increase procedural accuracy and brevity.

Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

“…4,19,31,33 Furthermore, labral reconstruction is among the most challenging procedures in hip arthroscopy, as evidenced by the handful of surgeons currently performing labral reconstructions. 18,35,36,44,46 This study has several strengths. Currently, literature is lacking on clinical outcomes and rate of return to sports after primary hip arthroscopy with labral reconstruction in the setting of FAI and irreparable labra.…”

“…5,11 Recently, restoring the labral seal mechanism via labral reconstruction has emerged as a viable option as a result of new technology and innovative surgical techniques. 8,35,38 Arthroscopic labral reconstruction is not only complex but also a relatively new procedure. 15,16,29,37,41,44 Limited literature is available on short-and midterm outcomes after hip labral reconstruction.…”

Reconstruction Guide for the Measurement of Segmental Labral Insufficiency: An Alternative Technique for Acetabular Labral Reconstruction

“…Perets et al. 14 describe a measureless technique using 1 anterior Arthrex PushLock anchor, a variable number of Knotless SutureTaks (Arthrex), and a semitendinosus graft that is amputated to the desired length using electrocautery after fixation. Although this technique reduces surgical time and measurement steps, it can cause graft displacement if overtightened and increases the technical difficulty of an already challenging procedure.…”

Hip Labral Augmentation With Tibialis Anterior Tendon Allograft Using the Knotless Pull-Through Technique

“…The knotless pull-through technique previously described and published by the senior author for labral reconstruction avoids the need to measure the defect. 10…”

“…Second, the pull-through technique previously described for labral reconstruction avoids the need to measure the labral defect and eliminates length mismatch. 10 Other advantages and disadvantages are presented in Table 2.…”