Literature DB >> 19341923

Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement.

Christopher M Larson1, M Russell Giveans.   

Abstract

PURPOSE: The purpose of this study was to compare the outcomes of arthroscopic labral debridement with those of labral refixation.
METHODS: We reviewed patients who underwent labral debridement during a period before the development of labral repair techniques. Patients with labral tears deemed repairable with our current arthroscopic technique were compared with patients who underwent labral refixation with a minimum 1 of year of follow-up. To better match the 2 groups, only patients with labral pathology caused by pincer-type or combined pincer- and cam-type femoroacetabular impingement were included. In the first 36 hips the labrum was debrided (group 1); in the next 39 hips the labrum underwent refixation (group 2). Outcomes were measured preoperatively and postoperatively with the modified Harris Hip Score (HHS), Short Form 12, and visual analog scale for pain. Preoperative and postoperative radiographs were obtained to evaluate bony resection (alpha angle) and osteoarthritis (Tönnis grade).
RESULTS: The mean age was 31 years in group 1, with a mean follow-up of 21.4 months, and 27 years in group 2, with a mean follow-up of 16.5 months. Preoperative subjective outcomes scores were not significantly different between groups. At the 1-year follow-up visit, subjective outcomes were significantly improved (P < .01) in both groups. HHSs were significantly better for the refixation group (94.3) compared with the debridement group (88.9) at 1 year (P = .029). At most recent follow-up, good to excellent results were noted in 66.7% of hips in the debridement group compared with 89.7% of hips in the refixation group (P < .01).
CONCLUSIONS: Although other variables could have influenced these outcomes, these preliminary results indicate that labral refixation resulted in better HHS outcomes and a greater percentage of good to excellent results compared with the results of labral debridement in an earlier cohort. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Entities:  

Mesh:

Year:  2009        PMID: 19341923     DOI: 10.1016/j.arthro.2008.12.014

Source DB:  PubMed          Journal:  Arthroscopy        ISSN: 0749-8063            Impact factor:   4.772


  103 in total

1.  No regeneration of the human acetabular labrum after excision to bone.

Authors:  Hermes H Miozzari; Marco Celia; John M Clark; Stefan Werlen; Florian D Naal; Hubert P Nötzli
Journal:  Clin Orthop Relat Res       Date:  2015-04       Impact factor: 4.176

2.  Treatment of posttraumatic labral interposition with surgical hip dislocation and labral repair.

Authors:  Jeffrey J Nepple; Perry L Schoenecker; John C Clohisy
Journal:  Iowa Orthop J       Date:  2011

Review 3.  Hip arthroscopy: evolution, current practice and future developments.

Authors:  Emmet J Griffiths; Vikas Khanduja
Journal:  Int Orthop       Date:  2012-02-28       Impact factor: 3.075

Review 4.  Femoroacetabular impingement in a professional soccer player.

Authors:  Robert E Boykin; Justin D Stull; J Erik Giphart; Coen A Wijdicks; Marc J Philippon
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2012-07-03       Impact factor: 4.342

Review 5.  The diagnosis and management of femoro-acetabular impingement.

Authors:  Robert J Macfarlane; Fares S Haddad
Journal:  Ann R Coll Surg Engl       Date:  2010-07       Impact factor: 1.891

6.  Are pelvic anatomical structures in danger during arthroscopic acetabular labral repair? Definition of safe bone depth.

Authors:  Arel Gereli; Baris Kocaoglu; Kerem Tekin Ulku; Abdul Veli Ismailoglu; Sena Silay; Mustafa Karahan
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2015-09-29       Impact factor: 4.342

7.  [Resection at symptomatic cam impingement. Use of a minimally invasive antero-lateral approach].

Authors:  Johannes Weihs; P Scacchi; R Hess; C E Albers
Journal:  Orthopade       Date:  2016-04       Impact factor: 1.087

8.  Evaluation of the sealing function of the acetabular labrum: an in vitro biomechanical study.

Authors:  C Signorelli; T Bonanzinga; N Lopomo; S Zaffagnini; M Marcacci; M Safran
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2015-11-14       Impact factor: 4.342

9.  Arthroscopic Hip Labral Reconstruction and Augmentation Using Knotless Anchors.

Authors:  Mark O McConkey; Brett Moreira; Omer Mei-Dan
Journal:  Arthrosc Tech       Date:  2015-11-16

Review 10.  Factors Associated With the Failure of Surgical Treatment for Femoroacetabular Impingement: Review of the Literature.

Authors:  Ehsan Saadat; Scott D Martin; Thomas S Thornhill; Sarah A Brownlee; Elena Losina; Jeffrey N Katz
Journal:  Am J Sports Med       Date:  2013-08-30       Impact factor: 6.202

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