keyword
https://read.qxmd.com/read/38450061/outcomes-following-open-acetabular-labrum-reconstruction-comparing-fresh-frozen-tendon-with-fresh-meniscus-allograft-transplantation
#1
JOURNAL ARTICLE
James L Cook, Kylee Rucinski, Robert Wissman, Cory Crecelius, Steven DeFroda, Brett D Crist
BACKGROUND: Symptomatic acetabular labral insufficiency in young, active patients is often treated with labral repair or reconstruction using fresh-frozen allografts. However, fresh-frozen tendon allografts do not have tissue or material properties that closely mimic acetabular labral fibrocartilage. Recent studies suggest meniscal allografts may be a better biomechanical, geometric, and material alternative for acetabular labrum reconstruction (ALR). HYPOTHESIS: Patients undergoing open ALR using fresh meniscus allograft transplants (MAT) will have better outcomes than those using fresh-frozen tendon allografts transplants (TAT) when comparing initial treatment success, diagnostic imaging assessments, and patient-reported pain and function scores...
July 2024: Journal of Orthopaedics
https://read.qxmd.com/read/38447625/trends-in-hip-arthroscopy-require-rapid-dissemination-from-higher-volume-and-academic-surgeons-to-the-greater-orthopaedic-community
#2
EDITORIAL
Christopher M Larson
Trends in hip arthroscopy show that labral repair and preservation, capsular repair and preservation, and treatment of FAI during hip arthroscopy are associated with superior short-term and mid- to longer-term outcomes. Hip arthroscopy, and in particular arthroscopic femoroacetabular impingement (FAI) correction, is in its infancy compared to many other orthopaedic procedures. As we assimilate knowledge, data, and evidence-based research, it is critical to evaluate surgical trends and how they affect our management of these patients and pathologies...
March 4, 2024: Arthroscopy
https://read.qxmd.com/read/38342282/primary-treatment-of-hip-labral-osseous-chondral-capsular-and-extra-articular-pathology-is-essential-outcomes-following-revision-are-less-predictable
#3
EDITORIAL
Benjamin D Kuhns, Benjamin G Domb
Appropriate labral management is one of many procedures during hip arthroscopy that affect postoperative outcomes and revision rates. Both primary labral repair and reconstruction have been shown to have superior clinical and functional outcomes compared to labral debridement when treating unstable labral tears. Arthroscopic labral reconstruction is one of the most powerful techniques in the arsenal of complex hip preservation surgeons, and while often reserved for the revision setting, when the native labrum is irreparable, a primary reconstruction may be indicated when the only alternatives are selective labral debridement or a sub-optimal repair...
February 9, 2024: Arthroscopy
https://read.qxmd.com/read/38336107/no-difference-in-most-reported-outcome-measures-for-allograft-versus-autograft-for-hip-labral-reconstruction-a-systematic-review-of-comparative-studies
#4
REVIEW
Muzammil Akhtar, Daniel Razick, Osamah Baig, Sonia Aamer, Shaheryar Asad, Carter Bernal, Anand Dhaliwal, Trevor Shelton
PURPOSE: To systematically review studies comparing outcomes of allograft versus autograft for hip labral reconstruction. METHODS: A systematic review following guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-analyses was performed in three databases using the terms "labrum," "hip," "acetabulum," "reconstruction," "augmentation," "allograft," and "autograft." Data for study characteristics, patient demographics, follow-up time, patient-reported outcomes (PROs), rates of revision surgery, and rates of conversion to total hip arthroplasty (THA) were collected...
February 7, 2024: Arthroscopy
https://read.qxmd.com/read/38333443/comparison-of-the-glenoid-index-by-computed-tomography-with-magnetic-resonance-imaging
#5
JOURNAL ARTICLE
Nida A Ahmed, Kailash Narendran, Nishath A Ahmed, Prashanth A, B Holebasu, Mihit Kalawatia, Kunal Dudeja, Parijat Kamble, Roshan Prasad, Gaurav Mittal, Ravi Sangoi
Introduction Anterior shoulder instability results in labral and osseous glenoid injuries. With a large osseous defect, there is a risk of recurrent dislocation of the joint, and therefore the patient has to undergo surgical correction. An MRI evaluation of the patient helps to assess the soft tissue injury. Currently, the volumetric three-dimensional (3D) reconstructed CT image is the standard for measuring glenoid bone loss and the glenoid index. However, it has the disadvantage of exposing the patient to radiation and additional expenses...
January 2024: Curēus
https://read.qxmd.com/read/38323953/editorial-commentary-extreme-hip-labral-size-both-small-and-large-shows-inferior-outcomes-after-arthroscopic-labral-repair-with-femoroacetabular-impingement-treatment
#6
EDITORIAL
Joseph C Brinkman
Arthroscopic management of hip femoroacetabular impingement shows reliable improvement in pain and patient-reported outcomes, high survivorship, and low conversion to total hip arthroplasty, particularly in the absence of dysplasia. Concomitant labral repair-or augmentation versus reconstruction when indicated- consistently shows better results than labral debridement. The effect of labral size on outcomes has been studies in several series. Some studies show that smaller labra show inferior outcomes after repair, others show labral size makes no difference in outcomes, and one showed that patients large labra actually had worse outcomes...
January 12, 2024: Arthroscopy
https://read.qxmd.com/read/38318815/the-contribution-of-soft-tissue-and-bony-stabilizers-to-the-hip-suction-seal-a-systematic-review-of-biomechanical-studies
#7
JOURNAL ARTICLE
Alexander J Hoffer, Wouter Beel, K C Geoffrey Ng, Ryan M Degen
BACKGROUND: Previous biomechanical studies have identified capsular closure, labral repair or reconstruction, and osteochondroplasty as important surgical interventions to improve hip stability. PURPOSE: To investigate the outcome metrics used to quantify hip stability and assess and measure the relative contributions of the labrum, capsule, and bone to hip stability through a quantitative analysis. STUDY DESIGN: Systematic review and meta-analysis; Level of evidence, 4...
February 6, 2024: American Journal of Sports Medicine
https://read.qxmd.com/read/38296454/editorial-commentary-irreparable-symptomatic-hip-labral-tears-should-be-reconstructed-in-patients-without-osteoarthritis-however-comparison-of-the-two-as-well-as-allograft-versus-autograft-reconstruction-is-challenging
#8
EDITORIAL
Justin R Zhu, Andrew E Jimenez
Hip acetabular labrum plays a chondroprotective role by maintaining stability, providing a suction seal, and contributing to load distribution. In symptomatic patients without osteoarthritis, arthroscopic labral repair has strong clinical and biomechanical data to support its use. For irreparable tears, the labrum should be reconstructed. Biomechanically, labral reconstruction does not demonstrate superiority when compared to labral repair or the intact native labrum state. However, it is superior to labral excision...
February 2024: Arthroscopy
https://read.qxmd.com/read/38296439/editorial-commentary-indications-for-acetabular-labral-debridement-versus-repair-and-reconstruction-there-is-still-a-role-for-selective-labral-debridement
#9
EDITORIAL
Timothy J Jackson
Not all acetabular labral tears, tissue quality, and size are the same. There is still a role for selective debridement of the acetabular labrum when stable, functional labral tissue remains. An unstable labrum that appears very different than the rest of the labrum is an easy target for repair. Tears requiring resection require graft augmentation or reconstruction.
February 2024: Arthroscopy
https://read.qxmd.com/read/38296438/editorial-commentary-small-labral-size-on-magnetic-resonance-imaging-is-an-indication-for-labral-reconstruction-in-the-setting-of-revision-hip-arthroscopy
#10
EDITORIAL
Parth Lodhia, Mark Owen McConkey
Revision hip arthroscopy is an increasingly common procedure as rates of primary hip arthroscopy rise. Etiologies for symptom recurrence may include residual femoroacetabular impingement, cam over-resection, labral pathology, chondral wear, adhesions, and instability. This has spawned sophisticated surgical techniques in hip arthroscopy including labral reconstruction. Indications for labral reconstruction in the revision setting obviously include labral deficiency. In addition, in the absence of other obvious reasons for failure of the primary procedure, a labral reconstruction should be considered for diminutive labra...
February 2024: Arthroscopy
https://read.qxmd.com/read/38238248/dynamic-anterior-stabilization-with-hill-sachs-remplissage-can-be-employed-in-skeletally-immature-patients-operative-technique
#11
JOURNAL ARTICLE
Diana-Cosmina Neculau, George Mihai Avram, Cosmin Simion, Vlad Predescu, Bogdan Obada, Ion-Andrei Popescu
BACKGROUND: Numerous studies indicate that glenoid bony augmentation raises the risk of complications during and after surgery. On the other hand, repairing the labrum alone in cases with subcritical glenoid bone loss results in recurrent instability and persistent apprehension. As a result, recent advancements in shoulder instability surgery prioritize fully restoring the anterior shoulder restraint. OPERATIVE TECHNIQUE: A novel method for treating recurrent anterior shoulder instability with subcritical glenoid bone loss and off-track Hill-Sachs lesion in skeletally immature patients is suggested: the use of dynamic anterior stabilization technique incorporating the long head of the biceps tendon onto the anterior glenoid rim via trans-subscapular transfer, in conjunction with Hill-Sachs remplissage...
January 18, 2024: Orthopaedic Surgery
https://read.qxmd.com/read/38219137/editorial-commentary-borderline-hip-dysplasia-combined-with-increased-anteversion-and-ligamentum-teres-disruption-is-a-recipe-for-hip-microinstability
#12
EDITORIAL
Yoan Bourgeault-Gagnon, Dan Cohen, Olufemi R Ayeni
The ligamentum teres (LT) is known to play a role as a secondary stabilizer of the hip joint. LT tears can be associated with hip instability. In patients with borderline developmental dysplasia of the hip (BDDH), the correlation between LT tears and microinstability is even more pronounced because of the increased mechanical stress placed on the ligament. This relationship may lead certain surgeons to consider new indications for LT reconstructions. However, caution is warranted regarding the potential role of LT reconstruction in these patients, particularly since the primary deficiency in BDDH is bony undercoverage...
September 5, 2023: Arthroscopy
https://read.qxmd.com/read/38219131/editorial-commentary-arthroscopy-with-labral-preservation-or-reconstruction-plus-capsular-closure-shows-excellent-outcome-in-patients-with-borderline-hip-dysplasia-and-is-less-invasive-than-periacetabular-osteotomy
#13
EDITORIAL
Fan Yang, Hongjie Huang, Jianquan Wang
Borderline developmental dysplasia of the hip (BDDH), or borderline hip dysplasia (BHD), traditionally characterized by a relatively low lateral center-edge angle (LCEA), presents a complex challenge in treatment due to its multifaceted etiology involving instability, femoroacetabular impingement (FAI), or a combination thereof. The optimal approach to managing adult BDDH remains a subject of significant debate. Periacetabular osteotomy (PAO) is considered the preferred treatment for addressing severe acetabular under-coverage, as it rectifies the underlying bony deficiency and promotes stability...
September 5, 2023: Arthroscopy
https://read.qxmd.com/read/38219101/editorial-commentary-iliotibial-band-autograft-is-a-safe-and-effective-technique-for-hip-labral-reconstruction
#14
EDITORIAL
Bradley M Kruckeberg, Marc J Philippon
Hip labral reconstruction is indicated for hypoplastic, ossified, or irreparable labral tears in the primary and revision settings. Arthroscopic reconstruction for insufficient labral tissue requires advanced surgical techniques to restore hip biomechanics and re-establish the suction seal. With the growing number of arthroscopic hip procedures being performed, this is an increasingly familiar scenario. In our experience, the iliotibial band (ITB) autograft provides a safe and effective technique for labral reconstruction at 10-year clinical follow-up...
December 29, 2023: Arthroscopy
https://read.qxmd.com/read/38154532/patients-undergoing-revision-hip-arthroscopy-with-labral-reconstruction-or-augmentation-demonstrate-favorable-patient-reported-outcomes-a-systematic-review
#15
REVIEW
Michael S Lee, Scott Fong, Amy Y Lee, Mackenzie Norman, Ronak J Mahatme, Nicholas Pettinelli, Nancy Park, Jack Gagné, Stephen M Gillinov, Wasif Islam, Andrew E Jimenez
PURPOSE: To review current literature evaluating patient-reported outcomes (PROs) and survivorship in patients undergoing revision hip arthroscopy with labral reconstruction or augmentation. METHODS: A systematic review was performed with the following keywords: (revision) AND (hip OR femoroacetabular impingement) AND (arthroscopy OR arthroscopic) AND (reconstruction OR augmentation OR irreparable). PubMed, Cochrane Trials, and Scopus were queried in October 2022 using the criteria established in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)...
December 26, 2023: Arthroscopy
https://read.qxmd.com/read/38123276/editorial-commentary-in-terms-of-hip-arthroscopy-long-term-outcomes-intra-articular-cartilage-damage-is-more-important-than-hip-labral-treatment-method-the-second-habit-of-highly-effective-surgeons
#16
EDITORIAL
Itay Ron, Mitch Yelton, Jacob Shapira
There is a large debate revolving around the optimal surgical management of hip labral tears. Currently, the literature tends to gravitate toward labral repair as the mainstay of treatment, followed by labral reconstruction when repair is not feasible. Some studies assert that there is no difference between labral repair versus debridement, whereas others support repair. Other studies support labral reconstruction. In the end, it is the quality of the cartilage that may be most important. Intra-articular cartilage damage is more important than the labral treatment method when it comes to hip arthroscopy long-term outcomes...
January 2024: Arthroscopy
https://read.qxmd.com/read/38092279/secondary-hip-labral-reconstruction-yields-inferior-minimum-2-year-functional-outcomes-to-primary-reconstruction-despite-comparable-intraoperative-labral-characteristics
#17
JOURNAL ARTICLE
Matthew R Yuro, Mark Kurapatti, Dominic S Carreira, Robroy Martin, Shane Nho, Andrew B Wolff
PURPOSE: To compare intraoperative labral characteristics and minimum 2-year functional outcomes of allograft labral reconstruction in primary versus revision hip arthroscopy across multiple orthopedic centers. METHODS: A retrospective multicenter hip arthroscopy registry was queried for patients with completed labral reconstruction surgeries from January 2014 to March 2023 with completed 2-year international Hip Outcome Tool-12 (iHOT-12) reports. Age, sex, and major intraoperative variables were also collected...
December 11, 2023: Arthroscopy
https://read.qxmd.com/read/38090926/posterior-glenoid-bone-block-reconstruction-indications-techniques-and-outcomes
#18
JOURNAL ARTICLE
Rajiv P Reddy, Matthew Como, Anya Singh-Varma, Amin Karimi, Julie Y Bishop, Albert Lin
Posterior shoulder instability is of particular therapeutic interest, as it typically affects patients with high functional demands such as young athletes and active adults. Although posterior capsulolabral repair has high return-to-sport rates, it is associated with recurrent instability of up to 11%. Posterior glenoid bone loss and significant glenoid retroversion have been identified as risk factors for recurrent instability and failure after primary arthroscopic soft-tissue repair. Therefore, posterior glenoid bone block reconstruction may be indicated for glenoid bone loss 20% or greater (as measured by the perfect circle technique) or greater than 10% in the setting of pathologic glenoid, failed primary posterior labral repair, incompetent posterior capsular tissue, or significant risk factors for failure of soft-tissue repair...
2024: Instructional Course Lectures
https://read.qxmd.com/read/38043570/hip-joint-contact-pressure-and-force-a-scoping-review-of-in-vivo-and-cadaver-studies
#19
Pedro Dantas, Sergio R Gonçalves, André Grenho, Vasco Mascarenhas, Jorge Martins, Miguel Tavares da Silva, Sergio B Gonçalves, José Guimarães Consciência
AIMS: Research on hip biomechanics has analyzed femoroacetabular contact pressures and forces in distinct hip conditions, with different procedures, and used diverse loading and testing conditions. The aim of this scoping review was to identify and summarize the available evidence in the literature for hip contact pressures and force in cadaver and in vivo studies, and how joint loading, labral status, and femoral and acetabular morphology can affect these biomechanical parameters. METHODS: We used the PRISMA extension for scoping reviews for this literature search in three databases...
December 4, 2023: Bone & Joint Research
https://read.qxmd.com/read/38013248/single-plane-3-dimensional-isotropic-spin-echo-magnetic-resonance-imaging-reconstructions-of-shoulder-exhibit-superior-correlation-to-surgical-findings-than-2-dimensional-dixon-multiplanar-magnetic-resonance-imaging
#20
JOURNAL ARTICLE
Shamrez Haider, Alison Cabrera, Uma Thakur, Yin Xi, Avneesh Chhabra
OBJECTIVE: The aim of the study is to evaluate concordance of multiplanar 2-dimensional magnetic resonance imaging (2D-MRI) versus 3D isotropic MRI for rotator cuff and labral tears with the reference standard of arthroscopic surgical findings. METHODS: It was an institutional review board-approved retrospective single-center study of consecutive preoperative patients with isotropic 3D-MRI on 3-Tesla scanners, multiplanar 2D-MRI, and shoulder arthroscopy. Scapular plane-oriented contiguous multiplanar reconstructions of 3D-images were evaluated by 2 experienced fellowship-trained musculoskeletal radiologists...
November 27, 2023: Journal of Computer Assisted Tomography
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