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

Alter, Thomas D.; Beck, Edward C.; Mehta, Nabil; Cancienne, Jourdan M.; Sarmast, Sara; Liu, Joseph N.; Nho, Shane J.

doi:10.1016/j.eats.2018.10.017

Cited by 9 publications

(9 citation statements)

References 14 publications

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“…Labral reconstruction can be performed using autograft or allograft tissue, and several arthroscopic labral restoration techniques have been described in the literature 4, 5, 6, 7, 8. The technique to measure labral defect size that uses an arthroscopic shoulder instrument to increase the accuracy by which intra-articular graft length is measured also has been recently described 9 . This technique offers a more precise and efficient way to measure labral defect size by using principles of graft measurement used in superior capsular reconstruction in the shoulder.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Acetabular Labrum Reconstruction and Remplissage of the Femoral Head–Neck Junction

Pérez-Carro¹,

Escajadillo²,

Escajadillo³

et al. 2019

Arthroscopy Techniques

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With the recent increase in the use of hip arthroscopy, revision hip arthroscopy also has become more prevalent; nevertheless, it is often complex, and many factors should be considered to achieve a satisfactory clinical outcome. Labral reconstruction or augmentation technique is used in cases of severely deficient acetabular labral tissue to restore the fluid seal mechanism. In cases of previous over-resection of cam impingement, the remplissage technique, used to restore the bony defect of the femoral headeneck junction and preserve the joint seal, is an established technique that has been recently reported in the hip with the use of iliotibial band with the same aim as in the shoulder, filling in of the defect due to healing of the soft tissue to the underlying bony impression. We aim to describe a labrum reconstruction in combination with a remplissage of the femoral headeneck junction with a dermal graft in a patient with recurrent hip pain after hip scope. This combination may improve hip stability and reduced pain after failed hip scope.

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Section: Discussionmentioning

confidence: 99%

Simultaneous Acetabular Labrum Reconstruction and Remplissage of the Femoral Head–Neck Junction

Pérez-Carro¹,

Escajadillo²,

Escajadillo³

et al. 2019

Arthroscopy Techniques

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“…A distal accessory AL portal was established, and the graft length was determined and fixed to the acetabular rim. 1 In cases of extensive cam deformity, a T-capsulotomy was performed to access the peripheral compartment. A comprehensive cam resection was performed to confirm resection of abnormal bony morphology.…”

Section: Methodsmentioning

confidence: 99%

Multicenter Outcomes After Revision Hip Arthroscopy: Comparative Analysis of 2-Year Outcomes After Labral Repair Versus Labral Reconstruction

Bodendorfer

Alter

Wolff³

et al. 2021

Am J Sports Med

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Background: There is a paucity of literature evaluating patient outcomes in patients undergoing revision labral repair and labral reconstruction. Purpose: To compare outcomes in patients undergoing revision hip arthroscopy for treatment of labral tears by labral repair or labral reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of a prospectively maintained multicenter database of patients undergoing hip arthroscopy was performed. An a priori power analysis determined that a total of 62 patients were required. Patients undergoing revision hip arthroscopy for labral tears with completed 2-year outcome scores were included. Patients undergoing primary hip arthroscopy, labral debridement, concomitant gluteal repair, and patients with hip dysplasia (lateral center-edge angle <20°) were excluded. Patients were grouped into revision labral repair and labral reconstruction groups. Patient demographics and patient-reported outcomes (PROs) including Hip Outcome Score – Activities of Daily Living, Hip Outcome Score – Sport Subscale, modified Harris Hip Score, international Hip Outcome Tool-12, visual analog scale for pain and satisfaction, and achievement of minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were analyzed. Results: A total of 40 patients underwent revision labral repair and 55 patients underwent labral reconstruction. Patients undergoing revision labral repair were younger (mean age, 30.0 ± 10.7 years vs 34.4 ± 9.7 years; P = .048), had lower rates of labral degeneration (25.0% vs 62.7%; P = .004), and had lower rates of severe complexity of tears (21.1% vs 66.0%; P = .003). However, the labral repair group had higher rates of articular cartilage damage (62.5% vs 33.3%; P = .009). There were no differences in any preoperative or 2-year postoperative PROs. Furthermore, no differences were seen in achievement of MCID or PASS in any PRO. Conclusion: In this multicenter study on revision hip arthroscopy, patients undergoing revision labral repair were younger and had better labral characteristics but greater cartilage damage compared with patients undergoing labral reconstructions. Despite these differences, patients who underwent labral repair reported similar outcomes to those undergoing labral reconstruction.

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“…The arthroscopic scalpel is then used to remove a crescentshaped segment of capsule approximately 5 mm in width and long enough to span the labral defect from either T-limb of the capsulotomy (Video 1 and Fig 1) The autograft is then prepared on the back table as previously described. 10 Two traction sutures are placed along the length of the T-capsulotomy (Video 1 and Fig 2 ).…”

Section: Graft Harvestmentioning

confidence: 99%

“…9 Multiple techniques have been described for labral reconstruction using both autograft and allograft sources. [10][11][12][13] Although no randomized controlled trials have been performed comparing the effectiveness of one particular technique, mid-term outcomes appear promising for many. 8 In particular, autograft sources appear ideal in consideration of the immunological advantage of native tissue as well as the potential cost savings.…”

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confidence: 99%

Arthroscopic Treatment of Femoroacetabular Impingement Using Labral Reconstruction with Capsular Autograft

DeFroda

Kester

Clapp

et al. 2021

Arthroscopy Techniques

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The acetabular labrum is essential for stability during physiologic motion of the hip. Labral repairs frequently are attempted in cases of primary tears, although labral reconstruction is an important alternative in the revision setting or in the primary setting when the tissue is unsalvageable. Labral reconstruction has been shown to restore the hip's suctionseal and fluid pressurization to that of the premorbid state, and cohort studies have demonstrated significantly improved patient-reported outcomes at midterm follow-up. Notably, the cost is of consideration during any reconstruction, and techniques have been described using both allograft and autograft sources. Autograft sources include the iliotibial band, ligamentum teres, gracilis tendon, and hip capsule. A previously described technique using the capsule was noted to hinder routine capsular closure. We present an alternative method for labral reconstruction using hip capsular tissue that is easily performed and allows for routine capsular closure.

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

Cited by 9 publications

References 14 publications

Simultaneous Acetabular Labrum Reconstruction and Remplissage of the Femoral Head–Neck Junction

Simultaneous Acetabular Labrum Reconstruction and Remplissage of the Femoral Head–Neck Junction

Multicenter Outcomes After Revision Hip Arthroscopy: Comparative Analysis of 2-Year Outcomes After Labral Repair Versus Labral Reconstruction

Arthroscopic Treatment of Femoroacetabular Impingement Using Labral Reconstruction with Capsular Autograft

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