Summary: Femoro-acetabular contact mechanics significantly worsened after segmental labrectomy. Reconstruction with a synthetic polyurethane scaffold reversed the loss in contact area and reduced both contact pressure and peak force caused by partial labrectomy. Contact area and peak force were normalized and the labral seal was re-established in the majority of cases.

Background

The acetabular labrum plays a major role in hip joint mechanics and restoration of labral function and is considered key for success in hip preservation surgery. The purpose of this study was to evaluate the effects of segmental labrectomy and defect reconstruction with a synthetic polyurethane scaffold (PS).

Methods

A cadaveric biomechanical study was performed using 10 hips from 5 fresh-frozen pelvises with an intact acetabular labrum without osteoarthritis. Using an intra-articular pressure measurement system (Tekscan), contact area (CA), contact pressure (CP) and peak force (PF) were assessed for the following conditions: 1) Intact labrum; b) Anterosuperior partial labrectomy; c) Reconstruction with PS. All specimens were analyzed for each condition in 4 positions: 90º flexion, 90º flexion plus internal rotation, 90º flexion plus external rotation, and 20º extension and with a labral seal test. The relative change from the intact condition (value = 1) was determined for all conditions and positions.

Results

When compared to the intact labrum, segmental labrectomy resulted in a significant decrease in CA (p<0.001) and a significant increase in PF (p<0.001) in all positions. CP (p<0.001) increased significantly in all positions except in extension (p=0.48). Following labrectomy, scaffold reconstruction of the segmental defect resulted in a significant increase in contact area as well as a significant decrease in contact pressure and peak force across all positions (p<0.05). In comparison to the intact labrum, scaffold reconstruction restored CA and PF to normal in all positions (p>0.05) whereas contact pressure was significantly decreased compared to labrectomy (p<0.05) but did not return to normal values (p>0.05). The labral seal was lost in all specimens following partial labrectomy and was restored in 80% of the specimens after scaffold labrum reconstruction.

Conclusions

Femoro-acetabular contact mechanics significantly worsened after segmental labrectomy. Reconstruction with a synthetic polyurethane scaffold reversed the loss in contact area and reduced both contact pressure and peak force caused by partial labrectomy. Contact area and peak force were normalized and the labral seal was re-established in the majority of cases.

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Correlation Between Arthro-MRI Results And Intraoperative Hip Arthroscopy Findings In Fai Syndrome ePoster Presentation Christian Sobau, MD, GERMANY Konstantinos Tramountanis, MD, GERMANY Wolfgang Miehlke, MD, GERMANY Alexander Zimmerer, MD, GERMANY
Can Hip Pain Be Treated With Tibial Malrotation Correction? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Long Term Outcomes After Arthroscopic Treatment Of Femoroacetabular Impingement For Patients With Borderline Dysplasia Abstract Presentation 4 minutes Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
The Radiographical Influence Of Torsional Deformity Of The Acetabular And Femur In Dysplastic Hips ePoster Presentation Carsten Heimer, BA, GERMANY Carsten Perka, MD, PhD, GERMANY Henrik Baecker, MD, GERMANY
Characterizing the Incidence of Avascular Necrosis after Corticosteroid Injections of the Hip Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Ahab Chopra, BA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Psychologically Distressed Patients Can Obtain Meaningful Clinical Benefit from Arthroscopic Hip Surgery ePoster Presentation Benjamin Saks, MD, UNITED STATES Rachel Glein, BS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Andrew Jimenez, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Female Athletes Demonstrate Greater Improvement in Patient Reported Outcome Scores and Equal Return To Sport Rates Compared to Males After Hip Arthroscopy A Gender Based Matched Comparison of High-Level Athletes Abstract Presentation 4 minutes Andrew Jimenez, MD, UNITED STATES Rachel Glein, BS, UNITED STATES Kara Miecznikowski, BS, UNITED STATES Benjamin Saks, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Benjamin G. Domb, MD, UNITED STATES
Labral Preserving Hip Arthroscopy and Bone Marrow Aspirate Injection for Patients with Symptomatic Labral Tears and Early Degenerative Changes Abstract Presentation 7 minutes Molly A Day, MD, UNITED STATES Kyle Hancock, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Hip Arthroscopy in Patients with Borderline Dysplasia. ePoster Presentation Leonel Perez Alamino, MD, ARGENTINA Daniel Fernando Veloz Serrano, Md, ARGENTINA Agustin Felipe Catan, MD, ARGENTINA Tomas Rafael Vilaseca, MD, ARGENTINA
Assessing Risk Of Osteonecrosis Of The Hip Following Intraarticular Injections: Hyaluronic Acid Versus Corticosteroid Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
What is the Association Between Anterior Cruciate Ligament Reconstruction and Femoroacetabular Impingement Surgery? An Analysis of Over 18,000 Hip Arthroscopies Abstract Presentation 6 minutes Clare Wise, BS , UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES Jeremy N. Truntzer, MD, UNITED STATES Robin Kamal, MD, MBA , UNITED STATES
Are Femoral And Tibial Derotation Osteotomies Effective In Improving Hip And Knee Pain And Function? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Mid-Term Outcome and Strength Assessment after Proximal Rectus-Femoris-Refixation in Athletes ePoster Presentation Maximilian Hinz, MD, GERMANY Stephanie Geyer, MD, GERMANY Felix Winden, Cand Med, GERMANY Alexander Braunsperger, B.Sc., GERMANY Florian Kreuzpointner, PhD, GERMANY Benjamin Daniel Kleim, MBBS, MD, MRes, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Julian Mehl, MD, GERMANY
Comparison Of Pull-Out Strength Following Ligamentum Teres Reconstruction In The Hip: Peek Corkscrew Suture Anchor Versus Cortical Button Fixation: A Cadaveric Study. Abstract Presentation 5 minutes Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES

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Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics

Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics

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Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics

Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics

Background

Methods

Results

Conclusions

More ISAKOS 2021: Global Content