Labral

BACKGROUND: Arthroscopic surgery in borderline dysplastic hips remains controversial, but the role of the ligamentum teres (LT) has not been studied in this setting. HYPOTHESIS: Borderline dysplastic patients with LT tears have worse short-term outcomes than those without LT tears. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data were prospectively collected on patients who underwent arthroscopic surgery between February 2008 and April 2014...

BACKGROUND: Studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) with associated labral tears. The purposes of this study were to report 10-year outcomes and hip survival following hip arthroscopy for FAI and to compare labral debridement with labral repair. METHODS: Prospectively collected data on patients followed for a minimum of 10 years after hip arthroscopy for FAI with either labral debridement or labral repair performed by a single surgeon were retrospectively analyzed...

The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM)...

In order to access and resect the acetabular rim, arthroscopic acetabuloplasty was described with labral detachment. When the chondrolabral junction remains intact, acetabuloplasty and labral refixation can be performed maintaining an unharmed labrum. We aimed to evaluate the outcome of a group of patients treated with arthroscopic acetabuloplasty without labral detachment. During the study period, we retrospectively analysed 44 patients with pincer-type o combined impingement and an intact chondroblabral junction, with an average follow-up of 32 months (range: 27-38)...

The purpose of this article is to determine normative values for the length of the acetabular rim and detect differences between gender, age, ethnicity, height and leg length. Six measurements were taken on the acetabular rim of 143 cadaveric skeleton specimens (286 acetabula) using a coordinate-measuring device: circumferential (excluding acetabular notch), anterior inferior iliac spine (AIIS)-anterior, AIIS-posterior, 12-3 o'clock, 12-9 o'clock and 11-5 o'clock. Museum specimen height data and leg length data from a previous study were recorded for 109 of 143 specimens...

Abductor lesions are increasingly recognized as a source of recalcitrant laterally based hip pain and dysfunction. There is a growing body of evidence that many of these may be amenable to endoscopic repair. To report the demographic data and outcomes of endoscopic hip abductor repair. Twelve patients underwent endoscopic abductor repair with 2-year follow-up. These patients were prospectively assessed with modified Harris hip and iHOT scores. The indications for surgery were clinical and MRI findings of symptomatic abductor tears that had failed conservative treatment...

This description shows the histological findings of a peroneus brevis tendon allograft used for labral reconstruction, implanted 8 weeks before being retrieved due to a postoperative complication unrelated to the graft. As far as we have knowledge this is the first description about revascularization of an allograft used for hip labral reconstruction. The histological report of the removed peroneus brevis tendon allograft shows evidence of vascular ingrowth represented by small vessels with a thin muscular wall in all layers of the graft and cellular migration mainly represented by mature fibroblasts...

To identify factors predicting failure after hip arthroscopy in patients with previous periacetabular osteotomy (PAO) defined as a conversion to total hip replacement (THR) and to evaluate the patient reported outcome scores. Of 55 hips treated with hip arthroscopy after PAO from Aug 2008 to 2012 at Aarhus University Hospital, 43 hips were included (median age: 36.1 yrs, range 16.3-56.9 yrs). Indications were unacceptable pain, a positive FABER and impingement test and signs of labral damage on MR-arthrography...

The objectives of this study are to survey the weight-bearing limitation practices and delay for returning to running and impact sports of high volume hip arthroscopy orthopedic surgeons. The study was designed in the form of expert survey questionnaire. Evidence-based data are scares regarding hip arthroscopy post-operative weight-bearing protocols. An international cross-sectional anonymous Internet survey of 26 high-volume hip arthroscopy specialized surgeons was conducted to report their weight-bearing limitations and rehabilitation protocols after various arthroscopic hip procedures...

BACKGROUND: Studies on midterm outcomes of the arthroscopic treatment of femoroacetabular impingement (FAI) and labral tears with mild osteoarthritis (OA) are limited. PURPOSE: To evaluate outcomes of the arthroscopic treatment of FAI and labral tears in patients with mild preoperative OA (Tönnis grade 1) at a minimum 5-year follow-up, and to perform a matched-pair comparison to a control group with Tönnis grade 0. STUDY DESIGN: Cohort study; Level of evidence, 3...

BACKGROUND: Advancements in instrumentation and techniques have extended the scope of hip arthroscopic surgery to treat complex osseous deformities that were previously best addressed with an open approach. Global pincer-type femoroacetabular impingement is an example of an abnormality requiring osseous correction with a technically challenging access point. PURPOSE: To report on the patterns of clinical presentation and intra-articular derangements, radiological associations, and minimum 2-year outcomes after hip arthroscopic surgery in patients with a lateral center edge angle (LCEA) >40° and profunda acetabulae in comparison with matched controls with normal acetabular coverage...

BACKGROUND: Femoroacetabular impingement (FAI) is a well-recognized condition that causes hip pain and can lead to early osteoarthritis if not managed properly. With the increasing awareness and efficacy of operative treatments for pincer-type FAI, there is a need for consensus on the standardized radiographic diagnosis. PURPOSE: To perform a systematic review of the evidence regarding imaging modalities and radiographic signs for diagnosing pincer-type FAI. STUDY DESIGN: Systematic review; Level of evidence, 4...

BACKGROUND: Hip arthroscopy has evolved into a well-established and rapidly growing field of orthopedic surgery for the management of labral tears. The purpose of this study was to review clinical outcomes of patients less than 25 years of age undergoing hip arthroscopy for treatment of a labral tear. METHODS: From 2005 to 2013, 82 hips in 76 patients with mean age of 20.4 (16-25 range) underwent hip arthroscopy for treatment of labral-chondral damage. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and hip disability and osteoarthritis outcome score (HOOS) were recorded at latest follow-up...

BACKGROUND: Periarticular injections have become a valuable adjunct to multimodal pain control regimens after knee and hip arthroplasties. Injection techniques vary greatly among surgeons with little standardization of practice. METHODS: We performed an extensive literature search to determine where nociceptive pain fibers are located in the hip and the knee and also to explore the pharmacology of periarticular cocktail ingredients. RESULTS: Large concentrations of nociceptors are present throughout the various tissues of the knee joint with elevated concentrations in the infrapatellar fat pad, fibrous capsule, ligament insertions, periosteum, subchondral bone, and lateral retinaculum...

PURPOSE: To compare the diagnostic performance of three-dimensional (3D) intermediate-weighted FSE (IW-3D) and 3D hybrid T1-weighted sequences (Hy-3D) and 2D fast-spin-echo sequences (FSE) in diagnosing chondral and labral lesions at 1.5 Tesla hip MR arthrography (MRA). MATERIALS AND METHODS: Institutional review board approval was obtained and informed consent was waived. Ninety-two consecutive patients were evaluated. Chondral and labral lesions were retrospectively and independently evaluated by two radiologists...

BACKGROUND: Iliopsoas (IP) muscle atrophy is a known consequence of open IP tenotomy, but the severity of IP muscle atrophy that occurs after arthroscopic labral-level IP tenotomies has not been documented. PURPOSE: To document the severity of muscle atrophy that occurs in the iliacus, psoas, and adjacent hip musculature after arthroscopic labral-level IP tenotomy. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Twenty-eight patients who had magnetic resonance arthrograms (MRAs) obtained prior to and 3 months to 5 years after arthroscopic labral-level IP tenotomies are the basis of this report...

The long head of the biceps tendon (LHBT) is a common source of pathology. The biceps-labral complex (BLC) is the collective anatomic and clinical features shared by the biceps tendon and the superior labrum. LHBT pathology can be caused by inflammation, instability, or trauma. Numerous tests can be performed to determine the existence of biceps tendon and superior labrum anterior to posterior (SLAP) lesions; however, many of these tests do not have high sensitivity and specificity, which limit their clinical utility...

BACKGROUND: Hip pain remains a challenge given the multiple factors that can cause damage to the articular cartilage, such as traumatic injury, metabolic damage, and morphologic variations such as femoroacetabular impingement (FAI) and that can contribute to progression of osteoarthritis. However, a direct relationship between patient characteristics, the extent of acetabular chondral damage, and topologic characteristics of chondral lesions has not been established. PURPOSE: To compare the grade of acetabular chondral damage, measured in terms of acetabular labrum articular disruption (ALAD) classification, to the size and position of the chondral lesions, matching patients' demographic factors such as age and body mass index (BMI)...

Chondral lesions are currently considered in the hip as a consequence of trauma, osteonecrosis, dysplasia, labral tears, loose bodies, dislocation, previous slipped capital femoral epiphysis and Femoro-Acetabular-Impingement (FAI). The management of chondral lesions is debated and several techniques are described. The physical examination must be carefully performed, followed by radiographs and magnetic resonance imaging (MRI). Differential diagnosis with other pathologies must be considered. Debridement is indicated in patients younger than 50 years with a chondropathy of 1st or 2nd degree...

Most surgeons create a T-shaped or interportal capsulotomy to ensure good visibility when performing hip arthroscopy. This entails transecting the iliofemoral ligament, which may or may not be repaired at the end of the procedure. Cases of iatrogenic hip instability and pain after hip arthroscopy suggest that the iliofemoral ligament plays a crucial role in the stability of the hip joint, and thus preservation should be a goal in hip arthroscopy. We describe a minimally invasive iliofemoral ligament-sparing capsulotomy, guided by the reflected head of the rectus tendon, that can be easily repaired after arthroscopic rim trimming, labral refixation, and offset correction...