The Biomechanical Case for Labral Débridement

Zaltz, Ira

doi:10.1007/s11999-012-2446-9

Cited by 16 publications

(10 citation statements)

References 44 publications

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“…In our series, the majority of patients had labral debridement with only a few patients having labral repair and none undergoing resection. There is continual evolution of whether debridement or repair is more appropriate (35). Due to limited numbers of labral repairs included in this study we were unable to provide specific recommendations in regards to how best manage the labrum; aside from stating that maximal preservation should always be strived for (36).…”

Section: Discussionmentioning

confidence: 99%

“…The term debridement refers to limited resection of frayed/torn labrum with the acetabular rim never being exposed whereas repair was done with suture anchors. The following procedures were performed; labral debridement alone (35); labral debridement with osteochondroplasty (33); labral repair alone (4); combined labral repair with osteochondroplasty (8); osteochondroplasty alone (2).…”

Section: Methodsmentioning

confidence: 99%

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Hip Arthroscopy in Patients Less than 25 Years of Age in the Treatment of Labral Tears: Aetiology and Clinical Outcomes

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Hip Arthroscopy in Patients Less than 25 Years of Age in the Treatment of Labral Tears: Aetiology and Clinical Outcomes

et al. 2017

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“…As a result of extent, location, and available tissue, some tears can be difficult to repair. Proponents of débridement argue that repair cannot restore normal biomechanical function of the labrum [59]. Bony deformities, specifically acetabular dysplasia and those causing FAI, are common in patients with labral injuries [41,57], and failure to correct these deformities has been linked to worse outcomes [7,17,29,32,38,42,46,47].…”

Section: Background Rationale and Study Findingsmentioning

confidence: 99%

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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“…Accurate determination of whether labral injury represents a tear or detachment can have clinical implications because labral detachments are commonly surgically treated by reattaching the labrum to the acetabular rim, and tears are commonly debrided. 67 Therefore, debridement of a labral detachment without reattachment could potentially lead to continued symptoms postoperatively.…”

Section: Routine Mrimentioning

confidence: 99%

Magnetic Resonance Imaging of the Hip

Omar

Blount²

2015

Topics in Magnetic Resonance Imaging

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Hip pain is common in all age groups, and osteoarthritis of this joint is an increasingly recognized problem particularly in aging populations. One of the primary goals in the diagnostic evaluation in patients with hip pain is to identify and correct pathologies that could progress to osteoarthritis. Magnetic resonance imaging (MRI) has become an important noninvasive method for characterizing hip anatomy and pathology in these patients. Improvements in MRI hardware and techniques have allowed high spatial and contrast resolution imaging to detect subtle abnormalities, such as acetabular labral and articular cartilage injuries, which often contribute to patient symptoms. Newer MRI techniques, such as delayed gadolinium-enhanced MRI of cartilage and T2 mapping, can give insight into the biochemical structure of tissues such as the articular cartilage. In turn, these can allow quantitative assessment and enable imagers to more directly compare the findings of patients at earlier stages of disease. It is important to understand the fundamental principles of various MRI techniques and their limitations to know when these techniques can best be applied. In addition, understanding of normal hip anatomy and common anatomic variants is useful for being able to accurately detect and localize areas of pathology and to prevent misinterpreting normal structures as diseased. The aims of this work were to briefly review normal hip anatomy and common anatomic variants seen on routine MRI examination, to discuss principles often used in high-resolution hip MRI and newer techniques for biochemical evaluation, and to examine several intra-articular pathologic conditions of the hip joint that are of current clinical interest.

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The Biomechanical Case for Labral Débridement

Cited by 16 publications

References 44 publications

Hip Arthroscopy in Patients Less than 25 Years of Age in the Treatment of Labral Tears: Aetiology and Clinical Outcomes

Hip Arthroscopy in Patients Less than 25 Years of Age in the Treatment of Labral Tears: Aetiology and Clinical Outcomes

No Regeneration of the Human Acetabular Labrum After Excision to Bone

Magnetic Resonance Imaging of the Hip

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