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Labrum surgery

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
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
Joseph W Galvin, Josef K Eichinger, Eric J Cotter, Alyssa R Greenhouse, Stephen A Parada, Brian R Waterman
Purpose: The purpose of this study is to evaluate the trends in surgical management for anterior shoulder instability in the U.S. Military. Methods: A retrospective analysis of military service members undergoing arthroscopic or open shoulder stabilization from 2012 to 2015 within the U.S. Military Health System was conducted. Demographic and surgical variables were extracted from the medical record. Chi-square and linear regression analysis were performed to identify temporal trends by surgical procedures and concomitant surgery...
February 6, 2018: Military Medicine
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
Adam Hines, Jay B Cook, James S Shaha, Kevin Krul, Steve H Shaha, John Johnson, Craig R Bottoni, Douglas J Rowles, John M Tokish
BACKGROUND: Glenoid bone loss is a well-accepted risk factor for failure after arthroscopic stabilization of anterior glenohumeral instability. Glenoid bone loss in posterior instability has been noted relative to its existence in posterior instability surgery. Its effect on outcomes after arthroscopic stabilization has not been specifically evaluated and reported. PURPOSE: The purpose was to evaluate the presence of posterior glenoid bone loss in a series of patients who had undergone arthroscopic isolated stabilization of the posterior labrum...
January 1, 2018: American Journal of Sports Medicine
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
Jacob Tulipan, Andrew Miller, Andrew G Park, Joseph T Labrum, Asif M Ilyas
BACKGROUND: Surgical educators are increasingly exploring surgical simulation and other nonclinical teaching adjuncts in the education of trainees. The simulators range from purpose-built machines to inexpensive smartphone or tablet-based applications (apps). This study evaluates a free surgery module from one such app, Touch Surgery, in an effort to evaluate its validity and usefulness in training for hand surgery procedures across varied levels of surgical experience. METHODS: Participants were divided into 3 cohorts: fellowship-trained hand surgeons, orthopedic surgery residents, and medical students...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
John D Higgins, Rachel M Frank, Jason T Hamamoto, Matthew T Provencher, Anthony A Romeo, Nikhil N Verma
Arthroscopic shoulder surgery can be performed in both the beach chair and lateral decubitus positions. The beach chair position is a reliable, safe, and effective position to perform nearly all types of shoulder arthroscopic procedures. The advantages of the beach chair position include the ease of setup, limited brachial plexus stress, increased glenohumeral and subacromial visualization, anesthesia flexibility, and the ability to easily convert to an open procedure. This position is most commonly used for rotator cuff repair, subacromial decompression, and superior labrum anterior-to-posterior repair procedures...
August 2017: Arthroscopy Techniques
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
Muhammet Baybars Ataoglu, Mehmet Cetinkaya, Mustafa Ozer, Tacettin Ayanoglu, Ulunay Kanatli
BACKGROUND: The purpose of this study was to assess the frequency of superior labrum anterior posterior (SLAP) lesions, long head of biceps tendon (LHBT) pathologies, and superior rotator cuff tears accompanying subscapularis tears. We hypothesised that LHBT lesions, superior rotator cuff tears, and especially SLAP lesions were very frequent with subscapularis tears. METHODS: The digital files of patients who underwent shoulder arthroscopy were reviewed retrospectively...
November 16, 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
U L Fahlenkamp, C Gerhardt, K-G A Hermann
Even primary diagnostic evaluation of the shoulder is a challenge for radiologists. Many imaging findings that definitely indicate abnormal findings in the untreated shoulder should be evaluated carefully in postoperative patients. Artifacts caused by implants or metal abrasion pose considerable problems in postoperative magnetic resonance imaging (MRI). Classic approaches to minimizing artifacts caused by foreign bodies include using turbo spin echo sequences, increasing bandwidth, and reducing voxel size...
November 2017: Der Radiologe
A Chopra, A J Grainger, B Dube, R Evans, R Hodgson, J Conroy, D Macdonald, Philip Robinson
OBJECTIVE: To compare the diagnostic accuracy of conventional 3T MRI against 1.5T MR arthrography (MRA) in patients with clinical femoroacetabular impingement (FAI). METHODS: Sixty-eight consecutive patients with clinical FAI underwent both 1.5T MRA and 3T MRI. Imaging was prospectively analysed by two musculoskeletal radiologists, blinded to patient outcomes and scored for internal derangement including labral and cartilage abnormality. Interobserver variation was assessed by kappa analysis...
October 6, 2017: European Radiology
António Cartucho, Nuno Moura, Marco Sarmento
BACKGROUND: Failed shoulder instability surgery is mostly considered to be the recurrence of shoulder dislocation but subluxation, painful or non-reliable shoulder are also reasons for patient dissatisfaction and should be considered in the notion. METHODS: The authors performed a revision of the literature and online contents on evaluation and management of failed shoulder instability surgery. RESULTS: When we look at the reasons for failure of shoulder instability surgery we point the finger at poor patient selection, technical error and an additional traumatic event...
2017: Open Orthopaedics Journal
Eduardo Sánchez Alepuz, Jaime Alonso Pérez-Barquero, Nadia Jover Jorge, Francisco Lucas García, Vicente Carratalá Baixauli
BACKGROUND: It is estimated that approximately 5% of glenohumeral instabilities are posterior. There are a number of controversies regarding therapeutic approaches for these patients. METHODS: We analyse the main surgery alternatives for the treatment of the posterior shoulder instability. We did a research of the publications related with posterior glenohumeral instability. RESULTS: There are conservative and surgical treatment options. Conservative treatment has positive results in most patients, with around 65 to 80% of cases showing recurrent posterior dislocation...
2017: Open Orthopaedics Journal
Robert W Westermann, T Sean Lynch, Morgan H Jones, Kurt P Spindler, William Messner, Greg Strnad, James Rosneck
BACKGROUND: Validated patient-reported outcome measures (PROMs) of hip pain and function at the time of arthroscopy could be predictors of the final outcome. Little is known about how patient factors or pathologic intra-articular findings relate to hip pain or function at the time of surgery for those presenting with femoroacetabular impingement (FAI). PURPOSE: To evaluate all patient and operative factors that contribute to hip pain and dysfunction in patients with FAI...
September 2017: Orthopaedic Journal of Sports Medicine
Joseph T Labrum, Asif M Ilyas
Purpose  Currently no guidelines exist for the timing of the injection of anesthetics in surgeries performed under general anesthesia to minimize postoperative pain. To better understand the role of timing of the injection of local anesthesia in hand surgery performed under general anesthesia, we evaluated the effect of pre- versus postincisional local analgesic injection on immediate postoperative pain experience. We hypothesize that the preincisional (preemptive) injection will result in decreased immediate postoperative pain experience and analgesic use when compared with postincisional injection...
August 2017: Journal of Hand and Microsurgery
Kyoung-Hwan Koh, Su Cheol Kim, Jae Chul Yoo
BACKGROUND: The purpose of this study was to evaluate the angle between the long head of the biceps tendon (LHBT) and the glenoid during arthroscopic surgery and its correlation with biceps subluxation on magnetic resonance imaging (MRI). Furthermore, we evaluated the relationship of this angle with subscapularis tears and biceps pathologies. METHODS: MRI and arthroscopic images of 270 consecutive patients who had undergone arthroscopic surgery were retrospectively evaluated...
September 2017: Clinics in Orthopedic Surgery
Ritesh Rathi, Jacek Mazek
BACKGROUND: The integrity of the acetabular labrum is crucial to normal biomechanics of the hip joint. Disruption of the labral seal could be detrimental to the overall nutrition of the cartilage, leading to its premature degeneration. PURPOSE: The aim of this study is to determine the clinical effectiveness of arthroscopic hip labral reconstruction using fascia lata allograft. The hypothesis is that labral reconstruction would provide good clinical outcomes. METHODS: We retrospectively reviewed all 10 patients who underwent labral reconstruction with fascia lata allograft from January 2013 to October 2015...
2017: Open Orthopaedics Journal
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