Treatment of failed arthroscopic acetabular labral debridement by femoral chondro-osteoplasty

May, Olivier; Matar, Wadih Y.; Beaulé, Paul E.

doi:10.1302/0301-620x.89b5.18753

Cited by 51 publications

(27 citation statements)

References 42 publications

(35 reference statements)

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“…Overall results of arthroscopic treatment for FAI show predictable functional improvement with good pain relief, equaling the results of open decompression with labral repair [36][37][38][39][40][41][42][43][44][45]. For the procedure to be successful, it is imperative to treat patients prior to the onset of significant joint space narrowing and degenerative changes.…”

Section: Results Of Surgical Management Of Faimentioning

confidence: 99%

Labral Tears and Femoroacetabular Impingement: Clinical Features and Arthroscopic Management

Martin¹,

Katz²

2012

Open Arth J

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Abstract:Context: Labral tears and femoroacetabular impingement (FAI) are increasingly recognized sources of hip pain and disability. FAI has two pathoanatomic phenotypes, Cam and Pincer impingement, and both of these lesions can cause labral tear and its associated symptoms, which can in turn lead to osteoarthritis. Hip arthroscopy is an increasingly popular technique with the potential to address these conditions.Evidence Acquisition: The authors performed a PubMed search on labral tears, FAI, and hip arthroscopy, and further refined the search by pulling relevant citations from the retrieved articles.Evidence Synthesis: Advances in hip arthroscopic techniques have made it possible to perform osteoplasty to treat the source of FAI and to perform labral repair. These procedures appear to be effective in relieving hip pain. However, randomized trials will be needed to perform a rigorous assessment of the efficacy of these procedures in pain relief. Longterm follow-up will be required to determine whether these surgical approaches reduce the risk of osteoarthritis. Conclusions:Clinicians should be aware of labral tears and FAI as common causes of hip and groin pain and disability. Successfully addressing these conditions with hip arthroscopy requires advanced training and a detailed knowledge of the anatomy of the hip. Results have been favorable, but further study is needed to fully document the outcomes of arthroscopic interventions.

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Section: Results Of Surgical Management Of Faimentioning

confidence: 99%

Labral Tears and Femoroacetabular Impingement: Clinical Features and Arthroscopic Management

Martin¹,

Katz²

2012

Open Arth J

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“…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%

“…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]. Therefore, some reviews imply that it may be possible to obtain comparably good results with simple débridement in subjects without FAI, arthrosis, or dysplasia [28].…”

Section: Background Rationale and Study Findingsmentioning

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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“…If conservative treatment fails and a surgical treatment is chosen, the prognosis depends not only on the presence of early OA, but also on the correction of the underlying deformity; if this is missed, resection of the labral tear will probably not yield the expected results (7)(8)(9)(10)(11) …”

mentioning

confidence: 99%

Acetabular labral tear: do not miss the underlying deformity. Comment on the article by Haroon et al

Reichenbach¹,

Jüni²,

Ganz³

et al. 2010

Arthritis Care & Research

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Treatment of failed arthroscopic acetabular labral debridement by femoral chondro-osteoplasty

Cited by 51 publications

References 42 publications

Labral Tears and Femoroacetabular Impingement: Clinical Features and Arthroscopic Management

Labral Tears and Femoroacetabular Impingement: Clinical Features and Arthroscopic Management

No Regeneration of the Human Acetabular Labrum After Excision to Bone

Acetabular labral tear: do not miss the underlying deformity. Comment on the article by Haroon et al

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