Labral Preservation: Outcomes Following Labrum Augmentation Versus Labrum Reconstruction

Philippon, Marc J.; Bolia, Ioanna K; Locks, Renato; Briggs, Karen K.

doi:10.1016/j.arthro.2018.04.021

Cited by 64 publications

(47 citation statements)

References 30 publications

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“…Thirtythree labral augmentation patients were matched 1:2 with patients undergoing labral reconstruction. 7 The authors found that, in their hands, higher clinical outcomes were observed in patients who had previous hip procedures and underwent labral augmentation HIP LABRAL AUGMENTATION e1213 versus labral reconstruction surgery. Similar revision rates and conversion to total hip arthroplasty were seen in both groups.…”

Section: Discussionmentioning

confidence: 98%

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

Maldonado

Chen

Lall

et al. 2019

Arthroscopy Techniques

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The importance of the labrum in the biomechanics of the hip joint is well documented. Labral tears are the most common pathology in patients undergoing hip arthroscopy and therefore appropriate labral management is vital. Labral preservation has been advocated as a superior alternative to labral excision in terms of clinical outcomes. While reconstruction of the labrum is recommended for irreparable tears, labral augmentation is a viable alternative for labral function restoration under certain indications. This Technical Note will describe a method for arthroscopic hip labral augmentation using an anterior tibialis tendon allograft and the pull-through technique.

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Section: Discussionmentioning

confidence: 98%

“…Philippon et al 7 reported their outcomes comparing labral augmentation versus reconstruction. Thirtythree labral augmentation patients were matched 1:2 with patients undergoing labral reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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

Maldonado

Chen

Lall

et al. 2019

Arthroscopy Techniques

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show abstract

“…In addition, all procedures were performed by a single surgeon, which may limit the generalizability of the results. Furthermore, capsular and labral management has evolved in the recent years and in consequence, patients who underwent labral debridement and capsular release in the ongoing study would currently be treated with labral restoration technique such labral reconstruction or labral augmentation, and capsular plication (23,24,(44)(45)(46). ConclusionRegardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements.…”

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confidence: 89%

Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

Maldonado

Yelton

Rosinsky

et al. 2019

Preprint

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Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting Patient Reported Outcomes (PROs) and return to play in competitive or recreational tennis players after hip arthroscopic surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and return to sport in tennis players who underwent hip arthroscopic surgery and (2) compare outcomes between recreational and competitive tennis players. Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement (FAI) and labral tears between March 2009 and January 2014 and who played tennis at any level within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patients with preoperative Tönnis osteoarthritis Grade >1, Workers’ Compensation claims, age > 60 years old, or previous ipsilateral hip surgeries or conditions were excluded. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% return to sport rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS. Conclusion: Regardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements. A favorable rate of return to sport was also achieved.

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“…5 Modern hip arthroscopic techniques including an emphasis on labral and capsular preservation only became prevalent over the last 5 years or so. 5,6 Although the hip capsule was not traditionally repaired in early hip arthroscopy, techniques and devices have improved to allow for either limited capsulotomy or complete closure of the capsule. 5 We originally reported revision hip arthroscopy for capsular repair in patients with previous unrepaired capsulotomy or minimal repair.…”

Section: See Related Article On Page 127mentioning

confidence: 99%

Editorial Commentary: The First Hip Arthroscopy Is the Best Hip Arthroscopy, Capsular Defect or Not

Wylie¹

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Hip arthroscopy has evolved significantly over the last 5 to 10 years. With this comes the burden of patients with continued pain after their index procedure. Reasons for the need for revision surgery can be many, including incomplete resection of impingement morphology, unrecognized/unaddressed acetabular dysplasia or hip instability, failure to manage the soft tissue appropriately (i.e., labrum or capsule/ligament), or other unrecognized cause of pain, like femoral retroversion or subspine impingement. Like many other orthopaedic procedures, revision hip arthroscopy with or without a defect in the hip capsule has significantly worse outcomes at 2 years compared with primary hip arthroscopy. This emphasizes the importance of proper diagnosis, well-done surgery, and proper rehabilitation the first time to avoid the need for revision hip surgery in the young adult altogether.

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Labral Preservation: Outcomes Following Labrum Augmentation Versus Labrum Reconstruction

Cited by 64 publications

References 30 publications

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

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

Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

Editorial Commentary: The First Hip Arthroscopy Is the Best Hip Arthroscopy, Capsular Defect or Not

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