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Hip labrum

Mitsufumi Nakawaki, Kensuke Fukushima, Gen Inoue, Mitsutoshi Moriya, Katsufumi Uchiyama, Naonobu Takahira, Masashi Takaso
The nature of pain associated with a labrum tear of the hip joint can vary widely among patients and does not always correlate with findings from diagnostic imaging. Identifying the components of the pain (nociceptive, neuropathic, or mixed pattern) is important to direct treatment. This report aimed to describe the use of the painDETECT questionnaire as a screening tool in order to classify the nature of the pain in three patients who presented with pain that was atypical for a labrum tear. The painDETECT questionnaire was an effective tool to identify appropriate pain management strategies in each case...
January 2018: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
Victor Ortiz-Declet, Brian Mu, Austin W Chen, Jody Litrenta, Leslie C Yuen, Stephanie M Rabe, Benjamin G Domb
Arthroscopic acetabuloplasty involves trimming of bone from the acetabular rim. Although early techniques often involved detachment of the labrum prior to bone resection, recent studies have reported on acetabuloplasty without labral detachment. This method has the benefit of preserving the labro-osseous junction, but visualization of the acetabular rim may be more difficult. Compromised visualization can lead to incomplete resection and residual impingement. We describe an arthroscopic perspective called the "bird's eye" and "upper deck" views that facilitates optimal visualization of the acetabuloplasty without labral detachment...
January 2018: Arthroscopy Techniques
Michael Ryan, Thomas Youm, Jonathan Vigdorchik
Hip arthroscopy as we know it today developed over the last 15 to 20 years, yet its true beginning is far more dated. Initially developed as a means of removing loose bodies or as a means of lavage, hip arthroscopy was not utilized to treat femoroacetabular impingement (FAI) until much later. Its usefulness as a means of treating FAI did not arise until hip impingement was understood to be causal in the development of degenerative changes of the labrum and articular surfaces. As our understanding of FAI grew, the tools for treating it developed in tandem...
March 2018: Bulletin of the Hospital for Joint Diseases
Renato Locks, Ioanna K Bolia, Hajime Utsunomiya, Karen K Briggs, Marc J Philippon
PURPOSE: To determine the causes of revision hip arthroscopy in patients who underwent labral reconstruction and to compare outcomes of these patients with patients who did not require a revision following reconstruction. METHODS: Patients who underwent revision hip arthroscopy after previous labral reconstruction from 2006 to 2014 were included. Patients with less than 2-year follow-up, preoperative joint space of ≤2 mm, or who underwent other reconstructive procedures at the time of labral reconstruction were excluded...
February 15, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ashley L Kapron, Stephen K Aoki, Jeffrey A Weiss, Aaron J Krych, Travis G Maak
PURPOSE: Develop a framework to quantify the size, location and severity of femoral and acetabular-sided cartilage and labral damage observed in patients undergoing hip arthroscopy, and generate a database of individual defect parameters to facilitate future research and treatment efforts. METHODS: The size, location, and severity of cartilage and labral damage were prospectively collected using a custom, standardized post-operative template for 100 consecutive patients with femoroacetabular impingement syndrome...
February 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andrea M Spiker, Kate R Gumersell, Ernest L Sink, Bryan T Kelly
In the realm of hip preservation, hip arthroscopy is often used to address intra-articular impingement pathology, whereas periacetabular osteotomy (PAO) is used to address dysplasia and instability. Indications to combine these 2 procedures include hip dysplasia and symptomatic instability with a concomitant symptomatic labral tear or the other symptomatic intra-articular pathology (i.e., loose body, chondral flap). The arthroscopic portion of the procedure allows repair of the injured labrum and close inspection of the hip joint, and the PAO addresses undercoverage and/or inappropriate version of the acetabulum...
October 2017: Arthroscopy Techniques
Patrick Finton Carton, David Filan
Arthroscopic labral 'takedown' and refixation is utilized to permit adequate visualization and resection of the acetabular rim deformity, in patients with pincer or mixed femoroacetabular impingement. Deficiencies exist in present techniques, which include disruption of vital anatomical support and vascular structures to the labrum and chondrolabral junction, drill or anchor articular penetration risk, bunching, elevation and instability of the labrum. A new operative technique is described which preserves the important chondrolabral interface, accurately restoring the 'flap seal' of the acetabular labrum while minimizing vascular disruption and reducing the risk of drill and anchor penetration...
January 2018: Journal of Hip Preservation Surgery
Renato Locks, Jorge Chahla, Ioanna K Bolia, Karen K Briggs, Marc J Philippon
The purpose of this study was to determine the outcomes following segmental labral reconstruction (labral defects measuring <1 cm) using a segment of capsular tissue or a segment of the indirect head of rectus femoris tendon. Eleven patients (five females and six males) underwent segmental labral reconstruction using a segment of capsule (eight patients) or indirect head of rectus tendon (three patients) by a single surgeon from March 2005 to October 2012. The average age of the patients was 35 years old (range, 20-51 years)...
January 2018: Journal of Hip Preservation Surgery
Jan Weidner, Michael Wyatt, Martin Beck
Preservation of an intact labrum and reconstruction of a deficient or worn acetabular labrum are accepted techniques in modern hip surgery. If the remaining labrum is very thin, its intact tip can be preserved and its volume restored with a ligamentum teres graft. Technique and preliminary results of this augmentation technique are presented. Labral augmentation was performed in 16 hips (11 rights) in 16 patients (7 males, mean age 29 years) during surgical dislocation for treatment of femoroacetabular impingement...
January 2018: Journal of Hip Preservation Surgery
Nathan W Skelley, William K Conaway, Scott D Martin
The prevalence of hip arthroscopy has increased exponentially with the advent of arthroscopic labral repair techniques for femoroacetabular impingement. The goal of arthroscopic labral repair is to re-create the anatomic suction seal of the labrum against the femoral head. This important anatomic relationship has been demonstrated in several biomechanical studies. Performing the acetabular recession and evaluating the congruity of labral repairs during surgery is difficult with the application of traction distracting the femoral head from the chondrolabral junction...
October 2017: Arthroscopy Techniques
Anne Le Bouthillier, Kawan S Rakhra, Etienne L Belzile, Ryan C B Foster, Paul E Beaulé
BACKGROUND: Clinically, understanding how the soft tissue envelope adapts to various forms of hip dysfunction could enhance both surgical and nonsurgical management. Very few studies have looked at soft tissue structures as preoperative discriminators between varying underlying etiologies of hip conditions. PURPOSE: To demonstrate that the magnetic resonance arthrography assessment of soft tissue structures of the hip will preoperatively differ in patients with different underlying hip joint diseases...
February 2018: Journal of Orthopaedic Trauma
Itay Perets, Edwin O Chaharbakhshi, David E Hartigan, Victor Ortiz-Declet, Brian Mu, Benjamin G Domb
PURPOSE: To evaluate a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) index designed to predict focal acetabular articular cartilage damage in patients with femoroacetabular impingement (FAI). METHODS: The inclusion criteria were patients who underwent dGEMRIC and hip arthroscopy between April 2010 and August 2015 for FAI syndrome. The exclusion criteria were previous hip conditions, a Tönnis grade greater than 1, and a delay between magnetic resonance imaging and surgery greater than 180 days...
January 17, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jocelyn N Todd, Travis G Maak, Gerard A Ateshian, Steve A Maas, Jeffrey A Weiss
Osteoarthritis of the hip can result from mechanical factors, which can be studied using finite element (FE) analysis. FE studies of the hip often assume there is no significant loss of fluid pressurization in the articular cartilage during simulated activities and approximate the material as incompressible and elastic. This study examined the conditions under which interstitial fluid load support remains sustained during physiological motions, as well as the role of the labrum in maintaining fluid load support and the effect of its presence on the solid phase of the surrounding cartilage...
January 16, 2018: Journal of Biomechanics
Songkiat Thanacharoenpanich, Sarah Bixby, Michael A Breen, Young-Jo Kim
BACKGROUND: Traumatic posterior hip dislocations in children and adolescents requires emergent closed reduction. Postreduction imaging is necessary to assess the concentricity of reduction and structural injuries to the hip. There is no a consensus for which imaging is a modality of choice in such condition. The purposes of this study are to describe magnetic resonance imaging (MRI) findings of traumatic posterior hip dislocations and to compare the effectiveness of MRI with computerized tomography (CT) in detecting structural abnormalities of the hip that impact patient management...
January 19, 2018: Journal of Pediatric Orthopedics
Kartik Shenoy, Amos Z Dai, Siddharth A Mahure, Daniel J Kaplan, Brian Capogna, Thomas Youm
The acetabular labrum and the transverse acetabular ligament form a continuous ring of tissue on the periphery of the acetabulum that provides a seal for the hip joint and increases the surface area to spread load distribution during weight-bearing. When a labral tear is suspected, the treatment algorithm always begins with conservative management, including physical therapy and nonsteroidal anti-inflammatory drugs. When conservative management fails, patients become candidates for arthroscopic labral repair...
December 2017: Arthroscopy Techniques
Luca Maria Sconfienza, Domenico Albano, Carmelo Messina, Enzo Silvestri, Alberto Stefano Tagliafico
OBJECTIVES: To perform an online survey about the use of magnetic resonance arthrography (MRA) in clinical practice. METHODS: We administered an online survey to all 1,550 members of the European Society of Musculoskeletal Radiology (ESSR) about MRA asking ten different questions. Subgroup analysis was performed between general and orthopaedic hospitals using χ2 and Mann-Whitney U statistics. RESULTS: One-hundred forty-eight answers were included (148/1,550, 9...
January 9, 2018: European Radiology
Soon Hyuck Lee, Woo Young Jang, Gi Won Choi, Young Keun Lee, Hae Woon Jung
PURPOSE: To investigate the arthroscopic pathoanatomy of the transverse acetabular ligament (TAL) and determine whether a TAL incision is necessary for the concentric reduction of developmental dysplasia of the hip (DDH) in infants and young children. METHODS: We retrospectively reviewed patients who underwent arthroscopic-assisted reduction for DDH between July 2008 and April 2016. The indications for this intervention included patients in whom closed reduction failed and those who did not require bone operations...
December 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Carlos Suarez-Ahedo, Chengcheng Gui, Stephanie M Rabe, John P Walsh, Sivashankar Chandrasekaran, Benjamin G Domb
Background: Hip arthroscopic surgery is intended to treat multiple abnormalities in an effort to delay the progression to osteoarthritis, especially in young patients. However, the length of time in which patients experience joint pain before seeking a specialist for a diagnosis can delay hip preservation surgery and influence clinical outcomes. Purpose: To investigate the relationship between age at symptom onset and findings during hip arthroscopic surgery as well as outcomes after 2 years of clinical follow-up...
November 2017: Orthopaedic Journal of Sports Medicine
Yasuhiro Shirai, Kenjiro Wakabayashi, Ikuo Wada, Yoshiaki Tsuboi, Myongsu Ha, Takanobu Otsuka
BACKGROUND: The Herring lateral pillar classification is widely used for the classification of Legg-Calvé-Perthes disease, but is not applied at the early stage of Legg-Calvé-Perthes disease because it is typically applied at the late fragmentation stage. The purpose of this study was to investigate the correlation between the early appearance on magnetic resonance imaging of the acetabular labrum and lateral pillar involvement in Legg-Calvé-Perthes disease. METHODS: Non-contrast magnetic resonance images of 26 hips in 25 children with early-stage Legg-Calvé-Perthes disease were retrospectively reviewed...
November 17, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Austin W Chen, Leslie C Yuen, Victor Ortiz-Declet, Jody Litrenta, David R Maldonado, Benjamin G Domb
BACKGROUND: Arthroscopic labral debridement in the hip can be an effective treatment for labral tears but has demonstrated inferior outcomes compared with labral repair. Thus, the role for labral debridement has become unclear. Hypothesis/Purpose: The purpose was to evaluate the outcomes of a selective debridement with labral preservation (SDLP) group with a minimum 5-year follow-up. It was hypothesized that, with narrow indications, SDLP would produce statistically improved patient-reported outcome (PRO) scores, comparable with those of a matched-pair labral repair control group...
November 1, 2017: American Journal of Sports Medicine
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