Labral

PURPOSE AND HYPOTHESIS: The aim of this study was to evaluate outcomes after acetabular labral reconstruction using the indirect head of the rectus femoris tendon. The study hypothesis stated that arthroscopic acetabular labral reconstruction may improve patient reported outcomes in patients with labral tears that were not amenable to repair. METHODS: Between 2009 and 2015, the senior author performed 31 acetabular labral reconstructions using the indirect head of the rectus femoris tendon...

OBJECTIVE: We report the largest case series of shoulder injuries among paddlers so far to establish common mechanisms and patterns of injury. We also discuss how these injuries were managed and report the proportion of paddlers that return to paddlesport. DESIGN: Case series. SETTING: Upper Limb Unit, Wrightington Hospital, United Kingdom. Manchester Arm Clinic, United Kingdom. PATIENTS: Fifty-seven shoulder injuries to professional and recreational paddlers were reviewed at a mean follow-up time of 55 months from the first consultation...

Arthroscopic labral reconstruction is an alternative procedure for an irreparable hip labrum in the nonarthritic hip population. Although labral reconstruction is a relatively new procedure, data in the literature show favorable outcomes. Patients have shown beneficial outcomes from labral reconstructive surgery as well as when compared with labral repair and debridement patients. However, one of the challenges in performing labral reconstruction has been correctly measuring the graft to perfectly fit the area of labral deficiency...

Posterior shoulder instability with glenoid bone loss has only a fraction of the prevalence of anterior instability. Unlike the latter, there is a paucity of literature regarding the treatment of posterior bony Bankart lesions and even less with concomitant reverse Hill-Sachs lesions. This combination of pathology leads to a difficult situation regarding treatment options. We present our technique for arthroscopic repair of a posterior bony Bankart lesion and reverse Hill-Sachs lesion. The importance of proper portal placement cannot be overstated...

This article describes the arthroscopic approach and management of a "reverse contre-coup" injury to the hip labrum. The injury occurs in the setting of posterolateral acetabular rim over-coverage impinging on the distal femoral neck in extension causing the femoral head to lever out anteriorly against the labrum. Ligamentous laxity and associated loss of anterior capsular restraint allow increased femoral head translation, adding further insult to the anterior labrum. The arthroscopic approach entails not only a labral repair with correction of the osseous conflict but also restoration of soft-tissue stability to minimize anterior femoral translation...

Hip cartilage injuries are very common, with rates as high as 50% having been reported in some series; abnormal femoral acetabular contact can result in a full-thickness cartilage defect or labral lesion. The prevalence of labral lesions can be as high as 55%. This Technical Note describes an arthroscopic technique to reconstruct an uncontained, full-thickness, focal cartilage defect of the acetabulum, with reconstruction of the missing labrum using a gracilis allograft and use of a biological liquid scaffold for cartilage reconstruction...

BACKGROUND: Studies on failed superior labrum anterior-posterior (SLAP) repair are increasing. However, the number of reports on treatment options for failed SLAP repair remains quite low, and the clinical results vary between different study groups. PURPOSE: To describe the clinical presentation of failed SLAP repair due to knot-induced pain and evaluate the efficacy of arthroscopic knot removal. STUDY DESIGN: Case series; Level of evidence, 4...

BACKGROUND: Failure of hip preservation to alleviate symptoms potentially subjects the patient to reoperation or conversion surgery to THA, adding recovery time, risk, and cost. A risk calculator using an algorithm that can predict the likelihood that a patient who undergoes arthroscopic hip surgery will undergo THA within 2 years would be helpful, but to our knowledge, no such tool exists. QUESTIONS: (1) Are there preoperative and intraoperative variables at the time of hip arthroscopy associated with subsequent conversion to THA? (2) Can these variables be used to develop a predictive tool for conversion to THA? MATERIALS AND METHODS: All patients undergoing arthroscopy from January 2009 through December 2011 were registered in our longitudinal database...

BACKGROUND: Prior studies revealed the presence of superior labrum anterior-to-posterior (SLAP) injury together with Bankart lesions in some patients. The purpose of the study is to compare the clinical results of isolated Bankart repairs with the clinical results of Bankart repairs when performed with concomitant SLAP repairs. METHODS: The patients who underwent arthroscopic surgery for treatment of anterior glenohumeral instability were evaluated retrospectively...

OBJECTIVES: Aim of this study was to evaluate the flexion-adduction-internal rotation (FADIR) test accuracy for screening cam and pincer morphology in youth male ice hockey players without diagnosed hip disorders. DESIGN: Cross-sectional study. METHODS: Seventy-four ice hockey players with a mean age of 16 years (range: 13-20 years) were assessed unilaterally. The presence of cam and pincer morphology was evaluated using the FADIR test and magnetic resonance imaging (MRI) (reference standard)...

In a single-surgeon study of more than 1,400 hip arthroscopies, 102 "adolescents" (aged 13-18) were operated on for labral tears. The authors highlighted significant differences between females and males although the final clinical results in both genders were comparable. In contrast to the nearly equal female-to-male ratio seen in most of the adult hip arthroscopy literature, there were >85% females and the authors described several anatomic differences that they stated affected their surgical approach.

OBJECTIVE: To compare the clinical outcome of arthroscopic surgery for femoroacetabular impingement (FAI) between athlete and nonathlete patients. DESIGN: Retrospective case-control study. Level of Evidence III. PATIENTS AND METHODS: Seventy-four patients who underwent arthroscopic FAI correction from March 2009 to April 2012 were enrolled in this study. The patients were divided into 2 groups, according to their sports participation (47 in the athlete group and 27 in the nonathlete group)...

Intra-articular lipoma of the hip is a rare entity, with only two reports published in the English-language literature. We present a case of successful arthroscopic resection of an intra-articular peripheral compartment lipoma in a 69-year-old woman with a coincident labral tear. This woman presented with left hip pain that developed gradually over 2 years and increased over 2 months. MRI showed a fat-intense mass in the anterior aspect of the hip joint, convincing for intra-articular lipoma. Physical examination in the operating room reproduced decreased range of motion and evidence of impingement but with a soft endpoint...

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...