Purpose: To perform a systematic review comparing outcomes of labral debridement/segmental resection with labral reconstruction as part of a comprehensive treatment strategy for femoroacetabular impingement.
Methods: A systematic review was conducted according to established PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines using defined inclusion and exclusion criteria. The study groups were divided into labral debridement/segmental resection (group 1) and labral reconstruction (group 2). Multiple search engines were queried (PubMed, Medline) for this analysis.
Results: After an exhaustive search of the available literature, 20 publications were included. Twelve studies explored outcomes after labral debridement/resection in a total of 400 hips, whereas 7 studies reported on outcomes after labral reconstruction in a total of 275 hips. One additional matched-pair control study compared labral resection (22 hips) with reconstruction (11 hips). The surgical intervention was a revision in 0% to 100% for group 1 versus 5% to 55% for group 2. A direct anterior approach was not performed in group 2, and cam-type impingement appeared to make up a larger percentage of group 1. The Tönnis grade ranged from 0 to 1 for group 1 versus 0.3 to 1.1 for group 2. Joint replacements were performed in 0% to 30% and 0% to 25%, respectively. The modified Harris Hip Score was the most widely used patient-reported outcome measure and suggested that labral reconstruction was not inferior to labral debridement/segmental resection.
Conclusions: Clinical outcomes after labral debridement/segmental resection versus labral reconstruction were found to be comparable. In the setting of unsalvageable labral pathology, labral reconstruction was used more frequently as a revision option whereas debridement may be more commonly used in the index setting.
Level Of Evidence: Level IV, systematic review of Level I, III, and IV studies.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arthro.2016.04.035 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Identifying a Reliable Intra-articular Landmark to Avoid Vascular Injury During Transacetabular Screw Fixation: A 3D Computed Tomography Study.
J Am Acad Orthop Surg
February 2025
From the Department of Orthopaedic Surgery, Keck Medical Center of the University of Southern California, Los Angeles, CA (Ihn, Chung, Lovro, Patterson, Christ, and Heckmann), the Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN (Chen), the Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA (Tucker), and the Department of Radiology, Keck Medical Center of the University of Southern California, Los Angeles, CA (White, and Hwang).
Introduction: Vascular injury during acetabular screw fixation is a life-threatening complication of total hip arthroplasty. This study uses three-dimensional computed tomography to (1) measure absolute distance from the external iliac artery (EIA) to the acetabulum, (2) determine available bone stock along the EIA path, and (3) create a novel acetabular vascular risk map.
Methods: A retrospective radiographic study was conducted using three-dimensional CT.
Neither Bone Marrow Aspirate Concentrate nor Platelet-Rich Plasma Improves Patient-Reported Outcomes After Surgical Management of Acetabular Labral Tears; However, Bone Marrow Aspirate Concentrate May Be Effective for Moderate Cartilage Damage: A Systematic Review.
Arthrosc Sports Med Rehabil
December 2024
Sports Medicine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
Purpose: To (1) systematically assess which orthobiologic agents are being used in acetabular labral repairs and (2) report all available outcomes for patients undergoing operative management for labral repairs with orthobiologic agents.
Methods: The PubMed, Embase, and Cochrane databases were queried in August 2023. Articles were included if they used an orthobiologic agent during hip arthroscopy for acetabular labral repair and reported functional outcomes.
Postless Hip Arthroscopy for Labrum Reconstruction and Labrum Augmentation.
Arthrosc Tech
November 2024
Ortopedika Hospital Hip Unit, Warsaw Poland.
Hip arthroscopy has been shown to be an effective surgical treatment with excellent outcomes and a low percentage of complications; however, there are published data regarding iatrogenic complications with hip distraction. Hip distraction is mandatory to gain access to the central compartment and to perform a reliable labral repair or labral reconstruction. Postless hip arthroscopy is very popular nowadays, and several techniques have been published.
View Article and Find Full Text PDFIn all aspects of orthopaedic surgery, restoring native patient anatomy has shown improved outcomes in comparison to nonanatomic reconstructions. Particular attention has been paid to the hip capsule, as the complex of the iliofemoral, pubofemoral, and ischiofemoral ligaments, as well as the zona orbicularis and iliocapsularis, all play an essential role in hip stability, mechanics, and maintenance of intra-articular pressures. An anatomic approach toward hip arthroscopy also includes labral repair or reconstruction with preservation of the chondrolabral junction and cam resection.
View Article and Find Full Text PDFArthroscopic Reconstruction of the Acetabular Labrum Using an Autograft Hip Capsule.
JBJS Essent Surg Tech
December 2024
Sports Medicine Center, Department of Orthopaedics, Massachusetts General Hospital, Mass General Brigham, Boston, Massachusetts.
Background: Whereas uncomplicated labral tears with preserved fibers can be effectively treated with use of labral repair techniques, complex tears and hypoplastic labra require labral reconstruction. Standard reconstruction techniques feature grafted tissue that is added to existing, deficient tissue or that is utilized to replace a hypoplastic labrum entirely. However, such approaches utilizing allografts or remote autografts are limited because they often necessitate extensive debridement of the existing labrum to prepare a site for graft implantation, an approach that can damage and devascularize the chondrolabral junction.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!