Repair of cartilage defects and torn acetabular labrum in hip joints after conventional osteotomy: evaluation by follow-up arthroscopy

Suzuki, Chise; Harada, Yoshitada; Mitsuhashi, Shin-ichi; Yamashita, Keishi; Watanabe, Hitoshi; Tsuchiya, Akihiro; Moriya, Hideshige

doi:10.1007/s00776-004-0871-7

Cited by 15 publications

(7 citation statements)

References 11 publications

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“…Synovitis was present in three hips, all of which had undergone previous labrum resection or débridement. In a separate investigation, Suzuki et al [23] performed a combination of acetabular and femoral osteotomies on 38 hips for the treatment of dysplasia. Second-look arthroscopy was carried out an average of 18.9 months after the index procedure to evaluate the cartilage and labral changes.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Hip Labrum Regrowth After Initial Surgical Débridement

Abrams

Safran

Sadri

2013

Clinical Orthopaedics &Amp; Related Research

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Background Anecdotal evidence from second-look hip arthroscopies and animal studies has suggested spontaneous labral regrowth may occur after débridement. However, these observations have not been systematically confirmed. Questions/purposes We (1) determined whether labral regrowth occurs after débridement in human hips; (2) if so, described the characteristics of the reconstituted labrum; and (3) determined the association, if any, of age with the presence and quality of labral regrowth. Methods We retrospectively reviewed all 24 patients who previously had open hip surgical dislocation with labral débridement for treatment of femoroacetabular impingement (FAI) and concomitant hip arthroscopy 2 years after index procedure in association with planned removal of trochanteric hardware between January and December 1999. Data recorded included amount of labral resection at the index procedure using the clockface method, presence and quality of any labral regrowth, presence of any labral scarring or inflammation, and WOMAC 1 scores. Minimum clinical followup was 11 years (average, 12 years; range, 11-12 years). Results All patients demonstrated labral regrowth at arthroscopy at 2 years. Homogeneous regrowth of labral height was seen in 21 of 24 patients, with labral scarring noted in four of 24. Average WOMAC 1 score was 98 points (range, 90-100 points) at the time of hardware removal. Increasing patient age was independently associated with decreased WOMAC

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Section: Discussionmentioning

confidence: 99%

Spontaneous Hip Labrum Regrowth After Initial Surgical Débridement

Abrams

Safran

Sadri

2013

Clinical Orthopaedics &Amp; Related Research

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“…Importantly, Suzuki et al [13] showed that cartilage lesions will often not improve after correction of the underlying pathologic mechanism. The authors completed second look arthroscopy after pelvic osteotomies and found no improvement in the majority of cases with regard to articular cartilage lesions present at the time of the index operation.…”

Section: Introductionmentioning

confidence: 99%

Operative treatment of chondral defects in the hip joint: a systematic review

Jordan

Thiel

Chahal

et al. 2012

Curr Rev Musculoskelet Med

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Young patients with cartilage defects in the hip present a complex problem for the treating physician with limited treatment modalities available. Cartilage repair/replacement techniques have shown promising results in other joints, however, the literature regarding the hip joint is limited. The purpose of the current study is to conduct a systematic review of clinical outcomes following various treatments for chondral lesions of the hip and define the techniques for the treatment of these cartilage defects. The full manuscripts of 15 studies were reviewed for this systematic review including case studies, case series, and clinical studies. A variety of techniques have been reported for the treatment of symptomatic chondral lesions in the hip. Microfracture, cartilage repair, autologous chondrocyte implantation, mosaicplasty, and osteochondral allografting have all been used in very limited case series. Although good results have been reported, most studies lack both a control group and a large number of patients. However, the reported results in this article do provide a good foundation for treatments and stimulant for further study in an inherently difficult to treat young patient population with articular cartilage defects in the hip.

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“…According to more recent studies, subjects with labral excision have lower scores at around two years than those with repairs [22,37]. Scarring between the capsule and the labrum-as observed here by the MRAs-has been found after acetabular osteotomy and both open and arthroscopic FAI surgery [1,18,34,53]. Beck [9] proposed that adhesions might interfere with the labral sealing mechanism and in fact advocated their débridement.…”

Section: Discussion Of Outcomesmentioning

confidence: 63%

“…Because we performed a resection to bone, it is difficult to compare our results with other studies where the amount of resection is unspecified [1,3,5,6,11,18,29,34,38,53] and was probably limited to partial débridement in many cases. We attempt to repair most labral tears, but the patients here had no option other than reconstruction with a graft, a procedure we had not adopted at the time.…”

Section: Discussionmentioning

confidence: 99%

“…Abrams et al [1] found a positive relationship between age and the presence of ''inhomogeneous regrowth'' of the labrum, and the average age of their subjects was 29 years. The condition of the labrum after various hip preservation procedures has been examined by arthroscopy [1,18,29,34,53], MRA [3,5,11,18], and during open procedures [6,38]. Overall, these reports contain only limited information on the extent of the initial labral resection.…”

Section: Discussion Of Imagingmentioning

confidence: 99%

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No Regeneration of the Human Acetabular Labrum After Excision to Bone

Miozzari

Celia

Clark

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Treatment options for a symptomatic, torn, irreparable, or completely ossified acetabular labrum are limited to either excision and/or reconstruction with grafts. In a previous animal model, regeneration of the acetabular labrum after excision to the bony rim has been shown. In humans, less is known about the potential of regeneration of the labrum. Recent studies seem to confirm labral regrowth, but it is still unclear if wide excision might be a surgical option in cases where repair is not possible.Questions/purposes The purposes of this study were (1) to determine the extent of acetabular labrum regeneration after excision to the bony rim; and (2) to determine whether this procedure results in higher hip scores. Methods We reviewed all patients treated with surgical dislocation for symptomatic femoroacetabular impingement by a single surgeon at one institution between 2003 and 2008, of whom 14 underwent wide labral excision (of at least 60°) down to bone; we used this approach when there was an absence of reparable tissue. Of these 14, nine were available for voluntary reexamination. The mean age at surgery was 38 ± 9 SD years and the mean followup was 4 ± 1 SD years. All patients consented to a physical examination and an MRI arthrogram, which was evaluated for evidence of new tissue formation by four observers. A modified Harris hip score and the UCLA were recorded.

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Repair of cartilage defects and torn acetabular labrum in hip joints after conventional osteotomy: evaluation by follow-up arthroscopy

Cited by 15 publications

References 11 publications

Spontaneous Hip Labrum Regrowth After Initial Surgical Débridement

Spontaneous Hip Labrum Regrowth After Initial Surgical Débridement

Operative treatment of chondral defects in the hip joint: a systematic review

No Regeneration of the Human Acetabular Labrum After Excision to Bone

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