Outcomes following arthroscopic hip segmental labral reconstruction using autologous capsule tissue or indirect head of the rectus tendon

Abstract

The purpose of this study was to determine the outcomes following segmental labral reconstruction (labral defects measuring <1 cm) using a segment of capsular tissue or a segment of the indirect head of rectus femoris tendon. Eleven patients (five females and six males) underwent segmental labral reconstruction using a segment of capsule (eight patients) or indirect head of rectus tendon (three patients) by a single surgeon from March 2005 to October 2012. The average age of the patients was 35 years old (range, 20–51 years). Data collected included the pre- and post-operative Hip Outcome Score (HOS-ADL and HOS-SS), the modified Harris Hip Score and patient satisfaction rate (1 = unsatisfied, 10 = very satisfied), complications, necessity of revision hip arthroscopy and conversion to total hip arthroplasty. Average follow-up time was at 62 months (range, 9–120 months). No patient required revision hip arthroscopy or converted to total hip arthroplasty. The HOS-ADL significantly improved from 73 to 89 (P < 0.05). The HOS-SS showed significant improvement from 52 to 79 and the modified Harris Hip Score significantly improved from 66 to 89. Median patient satisfaction rate was 9 out of 10 (range, 3–10). In a small sample, the arthroscopic hip segmental labral reconstruction showed significant improvement in patient-reported outcomes. This treatment provides an option in cases of small labrum defects (<1 cm) or deficits in patients while providing improved function and high patient satisfaction.

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

“…In such instances, the study with the largest patient sample (317 patients) was selected for inclusion. A total of seven studies were included in the final systematic review (15)(16)(17)(18)(19)(20)(21). A cross-reference of bibliographies of the included studies did not yield any additional studies for inclusion.…”

“…In addition to repair, reconstruction techniques have also been developed in order to treat patients with significant labral tears or insufficient labral tissue not amenable to repair (10)(11)(12)(13)(14)(15). Outcomes following reconstruction have also demonstrated significant improvements in patient reported pain and function in clinical studies (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Mechanistically, reconstruction of the labrum has demonstrated an ability to, at least in part, restore the stability of the suction seal effect as shown in in vitro studies (3)(4)(5).…”

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

“…Favorable short-term and mid-term outcomes have been reported for labral reconstructions. 5,[12][13][14][15] As with reconstruction, augmentation seeks to reestablish the labrum's sealing mechanism, which is critical for appropriate biomechanical function of the hip joint 6,16 (Fig 6D and Video 1).…”

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

“…Ongoing research has shown that successful labral reconstruction results in restored hip stability and suction seal similar to those in an intact state, and cohort studies have revealed significant improvement in patient-reported outcomes at midterm follow-up. 7 , 8 , 9 , 10 A critical component of labral reconstruction is accurately matching the graft length to the patient's native anatomy. 11 Mismatch between graft length and acetabular rim size can cause the graft to be overconstrained or too loose, making fixation more challenging and possibly compromising the suction seal between the graft and the femoral head.…”