Arthroscopic Labral Repair Associated with Femoroacetabular Impingement - Short Term 2-5 Years Follow-up Results -

Yoo-Sun Jeon; Deuk-Soo Hwang; Chan Kang; Jung-Mo Hwang; Gi-Soo Lee

doi:10.5371/hp.2013.25.2.115

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Jeon, Hwang, Kang, Hwang, and Lee: Arthroscopic Labral Repair Associated with Femoroacetabular Impingement - Short Term 2-5 Years Follow-up Results -

Original Article

Hip & Pelvis 2013; 25(2): 115-120.

Published online: 30 June 2013

DOI: https://doi.org/10.5371/hp.2013.25.2.115

Arthroscopic Labral Repair Associated with Femoroacetabular Impingement - Short Term 2-5 Years Follow-up Results -

Yoo-Sun Jeon, MD^*, Deuk-Soo Hwang, MD, Chan Kang, MD, Jung-Mo Hwang, MD, Gi-Soo Lee, MD

Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea.

^*Department of Orthopaedic Surgery, Bumin Hospital, Busan, Korea.

Address reprint request to Deuk-Soo Hwang, MD. Department of Orthopaedic Surgery, Chungnam National University School of Medicine, 33 Munwha-ro, Jung-gu, Daejeon 301-721, Korea. TEL: +82-42-280-7350, FAX: +82-42-252-7098, dshwang@cnu.ac.kr

Received 15 April 2013 Revised 19 June 2013 Accepted 20 June 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study is to report on the short term follow-up of patients who underwent arthroscopic acetabular labral repair for femoroacetabular impingement and acetabular labral tear.

Materials and Methods

A total of 45 consecutive patients who underwent arthroscopic acetabular labral repair after diagnosis of femoroacetabular impingement and acetabular labral tear from January 2008 to December 2010 were included in this study. Modified Harris hip score (MHHS), VAS, Hip outcomes score (HOS), and patient satisfaction were used for evaluation of the clinical results.

Results

Patients included 22 males and 23 females, and the mean age of the patients was 33.0(range, 16-54) years old, and the mean follow up period was 26.7(range, 24-56) months. Of the clinical results, mean VAS score was 6.4 and 2.5 points before and after surgery, respectively, and mean MHHS score improved from 59.5 points before surgery to 85.4 points after surgery. Activities of daily living and sports-related activities of HOS were 58.3% and 51.2%, respectively, before surgery, and 83.0% and 79.8% after surgery. Revision arthroscopic surgery was performed on five cases(12.1%); labro-synovial adhesion, three cases, pull-out of suture anchor, one case, heterotropic ossification, one case.

Conclusion

Arthroscopic acetabular labral repair is considered an effective treatment for femoroacetabular impingement and accompanying acetabular labral tear.

Keywords: Hip, Femoroacetabular impingement, Labral tear, Arthroscopy, Labral repair

Figures and Tables

Fig. 1

Preoperative computed tomography (CT) images of a 35 year old male patient shows bony spur on femur head-neck junction. Intraoperative arthroscopy images show labral tear and labral repair. Postoperative CT image shows resection state of bony spur.

Table 1

Preoperative and Postoperative Outcome Scores

^*VAS: visual analog scale, ^†MHHS: modified Harris hip score, ^‡HOS: hip outcomes score, ^§ADL: activities of daily living.

References

1. Takechi H, Nagashima H, Ito S. Intra-articular pressure of the hip joint outside and inside the limbus. Nihon Seikeigeka Gakkai Zasshi. 1982; 56:529–536.

2. Kim YT, Azuma H. The nerve endings of the acetabular labrum. Clin Orthop Relat Res. 1995; 176–181.

3. Altenberg AR. Acetabular labral tears: a cause of hip pain and degenerative arthritis. South Med J. 1977; 70:174–175.

4. Czerny C, Hofmann S, Neuhold A, et al. Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging. Radiology. 1996; 200:225–230.

5. McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The Otto E. Aufranc Award: The role of labral lesions to development of early degenerative hip disease. Clin Orthop Relat Res. 2001; 25–37.

6. Ferguson SJ, Bryant JT, Ganz R, Ito K. The acetabular labrum seal: a poroelastic finite element model. Clin Biomech (Bristol, Avon). 2000; 15:463–468.

7. Ferguson SJ, Bryant JT, Ganz R, Ito K. The influence of the acetabular labrum on hip joint cartilage consolidation: a poroelastic finite element model. J Biomech. 2000; 33:953–960.

8. Ferguson SJ, Bryant JT, Ganz R, Ito K. An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomech. 2003; 36:171–178.

9. Petersen W, Petersen F, Tillmann B. Structure and vascularization of the acetabular labrum with regard to the pathogenesis and healing of labral lesions. Arch Orthop Trauma Surg. 2003; 123:283–288.

10. Tan V, Seldes RM, Katz MA, Freedhand AM, Klimkiewicz JJ, Fitzgerald RH Jr. Contribution of acetabular labrum to articulating surface area and femoral head coverage in adult hip joints: an anatomic study in cadavera. Am J Orthop (Belle Mead NJ). 2001; 30:809–812.

11. Larson CM, Giveans MR. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy. 2009; 25:369–376.

12. Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am. 2006; 88:925–935.

13. Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br. 2009; 91:16–23.

14. Suenaga E, Noguchi Y, Jingushi S, et al. Relationship between the maximum flexion-internal rotation test and the torn acetabular labrum of a dysplastic hip. J Orthop Sci. 2002; 7:26–32.

15. Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome. A clinical presentation of dysplasia of the hip. J Bone Joint Surg Br. 1991; 73:423–429.

16. Lage LA, Patel JV, Villar RN. The acetabular labral tear: an arthroscopic classification. Arthroscopy. 1996; 12:269–272.

17. Hwang DS, Lee WS, Kwon YS, Hong CH. The usefulness of hip arthroscopy. J Korean Orthop Assoc. 2002; 37:587–593.

18. Kelly BT, Weiland DE, Schenker ML, Philippon MJ. Arthroscopic labral repair in the hip: surgical technique and review of the literature. Arthroscopy. 2005; 21:1496–1504.

19. Hwang DS, Lee WS, Kim YM, Nam DC, Kang C. Age-related morphologic and pathologic features of acetabular labrum in the adult hip. J Korean Orthop Assoc. 2003; 38:355–360.

20. Kelly BT, Shapiro GS, Digiovanni CW, Buly RL, Potter HG, Hannafin JA. Vascularity of the hip labrum: a cadaveric investigation. Arthroscopy. 2005; 21:3–11.

21. Seldes RM, Tan V, Hunt J, Katz M, Winiarsky R, Fitzgerald RH Jr. Anatomy, histologic features, and vascularity of the adult acetabular labrum. Clin Orthop Relat Res. 2001; 232–240.

22. Philippon MJ, Arnoczky SP, Torrie A. Arthroscopic repair of the acetabular labrum: a histologic assessment of healing in an ovine model. Arthroscopy. 2007; 23:376–380.

23. Song Y, Ito H, Kourtis L, Safran MR, Carter DR, Giori NJ. Articular cartilage friction increases in hip joints after the removal of acetabular labrum. J Biomech. 2012; 45:524–530.

24. Streich NA, Gotterbarm T, Barié A, Schmitt H. Prognostic value of chondral defects on the outcome after arthroscopic treatment of acetabular labral tears. Knee Surg Sports Traumatol Arthrosc. 2009; 17:1257–1263.

25. Harris JD, McCormick FM, Abrams GD, et al. Complications and reoperations during and after hip arthroscopy: a systematic review of 92 studies and more than 6,000 patients. Arthroscopy. 2013; 29:589–595.

26. Papavasiliou AV, Bardakos NV. Complications of arthroscopic surgery of the hip. Bone Joint Res. 2012; 1:131–144.

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