Jun-Il Yoo1, Yong-Chan Ha2, Young-Kyun Lee1, Guen-Young Lee3, Moon-Jib Yoo4, Kyung-Hoi Koo1. 1. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Bundang Hospital, Seoul, Republic of Korea. 2. Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea. Electronic address: hayongch@naver.com. 3. Department of Radiology, Chung-Ang University College of Medicine, Seoul, Republic of Korea. 4. Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea.
Abstract
PURPOSE: To investigate smaller sized labra after acetabular labral repair comparing preoperative and postoperative computed tomography arthrography (CTA) and to assess the correlation between the anatomic changes and clinical outcomes. METHODS: The design and protocol of this retrospective study were approved by the institutional review board of our hospital. The inclusion criteria included age older than 18 years and hip pain associated with mechanical symptoms. Patients with previous hip surgery, avascular necrosis, rheumatologic disorders, or advanced arthritis were excluded. All tears with femoroacetabular impingement were treated with bumpectomy or acetabuloplasty and repaired using arthroscopic suture anchors. We evaluated clinical outcomes using the modified Harris Hip Score (mHHS) and the morphologic changes and radiologic outcomes (labral retear and leakage of dye) using CTA at a minimum 2-year follow-up. The paired t test was performed to detect changes in labral height, labral width, and mHHS. RESULTS: Forty labral tears in 40 patients (mean age, 32.1 ± 9.2 years) underwent labral repair, with femoroplasty in 20 hips and acetabuloplasty in 17 hips, and no patients required capsular repair after capsulotomy. No leakage of contrast dye was detected during the follow-up CTA procedure. No labral retears were observed after labral refixation at the postoperative CTA evaluation. However, the mean width and height of the labrum changed from 8.1 mm and 4.9 mm, respectively, preoperatively to 6.7 mm and 4.4 mm, respectively, at the postoperative follow-up (decreasing by 19% and 11%, respectively; both P < .001). In addition, the mean mHHS for the 36 patients in the complete repair group improved from 61 ± 16.0 to 90 ± 9.6 (P = .01). Four hips showed incomplete repairs. CONCLUSIONS: Repaired labra are well maintained after capsulotomy based on follow-up CTA after arthroscopic labral repair. In addition, decreased height and width of the labra do not affect the clinical outcomes. LEVEL OF EVIDENCE: Level IV, therapeutic study (case series [no, or historical, control group]).
PURPOSE: To investigate smaller sized labra after acetabular labral repair comparing preoperative and postoperative computed tomography arthrography (CTA) and to assess the correlation between the anatomic changes and clinical outcomes. METHODS: The design and protocol of this retrospective study were approved by the institutional review board of our hospital. The inclusion criteria included age older than 18 years and hip pain associated with mechanical symptoms. Patients with previous hip surgery, avascular necrosis, rheumatologic disorders, or advanced arthritis were excluded. All tears with femoroacetabular impingement were treated with bumpectomy or acetabuloplasty and repaired using arthroscopic suture anchors. We evaluated clinical outcomes using the modified Harris Hip Score (mHHS) and the morphologic changes and radiologic outcomes (labral retear and leakage of dye) using CTA at a minimum 2-year follow-up. The paired t test was performed to detect changes in labral height, labral width, and mHHS. RESULTS: Forty labral tears in 40 patients (mean age, 32.1 ± 9.2 years) underwent labral repair, with femoroplasty in 20 hips and acetabuloplasty in 17 hips, and no patients required capsular repair after capsulotomy. No leakage of contrast dye was detected during the follow-up CTA procedure. No labral retears were observed after labral refixation at the postoperative CTA evaluation. However, the mean width and height of the labrum changed from 8.1 mm and 4.9 mm, respectively, preoperatively to 6.7 mm and 4.4 mm, respectively, at the postoperative follow-up (decreasing by 19% and 11%, respectively; both P < .001). In addition, the mean mHHS for the 36 patients in the complete repair group improved from 61 ± 16.0 to 90 ± 9.6 (P = .01). Four hips showed incomplete repairs. CONCLUSIONS: Repaired labra are well maintained after capsulotomy based on follow-up CTA after arthroscopic labral repair. In addition, decreased height and width of the labra do not affect the clinical outcomes. LEVEL OF EVIDENCE: Level IV, therapeutic study (case series [no, or historical, control group]).
Authors: Ida Lindman; Sarantos Nikou; Axel Öhlin; Eric Hamrin Senorski; Olufemi Ayeni; Jon Karlsson; Mikael Sansone Journal: J Exp Orthop Date: 2021-04-23