Literature DB >> 23644149

Acetabular labral reconstruction with an iliotibial band autograft: outcome and survivorship analysis at minimum 3-year follow-up.

Mark R Geyer1, Marc J Philippon, Theodore S Fagrelius, Karen K Briggs.   

Abstract

BACKGROUND: Injury to the acetabular labrum results from multiple causes including femoroacetabular impingement, dysplasia, and acute trauma. The patient's labrum can be reconstructed utilizing an iliotibial band autograft that is tubularized and fixed to the acetabular rim, substituting for the patient's own labrum. Purpose/ HYPOTHESIS: The purpose of this study was to evaluate the midterm results of this technique with a follow-up from 3 to 6 years after reconstruction. The hypothesis was that midterm results would show excellent patient-reported outcomes and high patient satisfaction with outcome. STUDY
DESIGN: Case series; Level of evidence, 4.
METHODS: A retrospective review of a prospectively collected registry was undertaken that identified 75 patients (76 hips) who underwent arthroscopic labral reconstruction using an iliotibial band autograft by a single surgeon from February 2005 to August 2008. Modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and patient satisfaction level (on a scale of 1-10) were recorded preoperatively and postoperatively annually. Survivorship analysis curves were created to evaluate the effectiveness of this technique.
RESULTS: Among 76 hips, 19 progressed to total hip arthroplasty at an average of 28 months from the procedure. Mean survivor time (no arthroplasty) was 59.1 months (95% CI, 53.9-64.4). Follow-up on the surviving hips was available for 49 patients (86%) with a mean follow-up time of 49 months (range, 36-70 months). The mHHS significantly increased from a preoperative mean of 58.9 to the most recent follow-up score averaging 83 (P = .0001); HOS values in the sports and the activities of daily living subscales also increased significantly (P = .0001 and P = .001, respectively). Median patient satisfaction with outcome was 8. A joint space of ≤2 mm was found to be a poor prognostic factor for survival of the hip.
CONCLUSION: Arthroscopic labral reconstruction using an iliotibial band autograft resulted in a survivorship of 56 months. Of the 76% of patients who did not require total hip arthroplasty, improvement in function and high satisfaction with outcome were reported. Joint space of ≤2 mm is a contraindication for acetabular labral reconstruction.

Entities:  

Keywords:  autograft; femoroacetabular impingement; iliotibial band; labral reconstruction; labrum

Mesh:

Year:  2013        PMID: 23644149     DOI: 10.1177/0363546513487311

Source DB:  PubMed          Journal:  Am J Sports Med        ISSN: 0363-5465            Impact factor:   6.202


  37 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
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2.  Treatment of pincer-type femoroacetabular impingement.

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Journal:  Joints       Date:  2015-11-03

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

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4.  Circumferential Labral Reconstruction Using the Knotless Pull-Through Technique-Surgical Technique.

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5.  Arthroscopic Hip Labral Augmentation Technique With Iliotibial Band Graft.

Authors:  Renato Locks; Jorge Chahla; Jonathan M Frank; Jack Anavian; Jonathan A Godin; Marc J Philippon
Journal:  Arthrosc Tech       Date:  2017-03-20

6.  The hip fluid seal--Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction.

Authors:  Jeffrey J Nepple; Marc J Philippon; Kevin J Campbell; Grant J Dornan; Kyle S Jansson; Robert F LaPrade; Coen A Wijdicks
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2014-02-09       Impact factor: 4.342

7.  The hip fluid seal--Part I: the effect of an acetabular labral tear, repair, resection, and reconstruction on hip fluid pressurization.

Authors:  Marc J Philippon; Jeffrey J Nepple; Kevin J Campbell; Grant J Dornan; Kyle S Jansson; Robert F LaPrade; Coen A Wijdicks
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2014-02-12       Impact factor: 4.342

8.  Hip capsulolabral spacer placement for the treatment of severe capsulolabral adhesions after hip arthroscopy.

Authors:  Marc J Philippon; Fernando P Ferro; Jeffrey J Nepple
Journal:  Arthrosc Tech       Date:  2014-04-21

9.  Arthroscopic labralization of the hip: an alternative to labral reconstruction.

Authors:  Dean K Matsuda
Journal:  Arthrosc Tech       Date:  2014-01-31

10.  Arthroscopic Labrum Reconstruction in the Hip Using the Indirect Head of Rectus Femoris as a Local Graft: Surgical Technique.

Authors:  Zachary T Sharfman; Eyal Amar; Thomas Sampson; Ehud Rath
Journal:  Arthrosc Tech       Date:  2016-04-11
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