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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Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy ePoster Presentation Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Cort D. Lawton, MD, UNITED STATES Matthew S. Dooley, MA, 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
Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair ePoster Presentation Heath Patrick Gould, MD, UNITED STATES William Rate, MS, MD, UNITED STATES Matthew Civilette, MD, UNITED STATES John Hamilton, MD, UNITED STATES James Dreese, MD, UNITED STATES
Not Every Hip Impingement Requires Hip Arthroscopy. 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
Predicting Dissatisfaction Following Total Hip Arthroplasty Using A Bayesian Model Averaging (Bma) Approach: Results From The Australian Arthroplasty Clinical Outcomes Registry (Acorn) ePoster Presentation Jan Peter Van Meirhaeghe, MD, BELGIUM Rob Molnar, MBBS, AUSTRALIA Sam Adie, BSc(Med) MBBS MSpMed MPH PhD FRACS, AUSTRALIA
Hip Osteochondroplasty May Benefit The Non-Ideal Patient With Femoroacetabular Impingement: Analysis From The Embedded Prospective Cohort Of The First Trial Abstract Presentation 6 minutes Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Diane Heels-Ansdell, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Outcome Measures After Proximal Hamstring Repair: A Systematic Review ePoster Presentation Tara Reza, MPH, UNITED STATES Andre Gordon Perez-Chaumont, BS, UNITED STATES Andrew J Hinkle, BS, UNITED STATES Symone M Brown, MPH, UNITED STATES Mary K. Mulcahey, 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
Is Arthroscopy An Adequate Therapy For All Borderline Dysplastic Hips? Correlation Between Radiologic Findings And Clinical Outcomes Abstract Presentation 6 minutes Alexander Zimmerer, MD, GERMANY Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY
Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain? Abstract Presentation 5 minutes Daniel Curtis, MD, UNITED STATES William Michael Pullen, MD, UNITED STATES Christopher Jamero, MA, ATC, UNITED STATES Marc R. Safran, MD, Prof., 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
A Comparison Of Perioperative Outcomes Between Patients Who Underwent Hip Arthroscopy With And Without The Pericapsular Nerve Group Block ePoster Presentation Albert A Yusupov, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Christopher J Mazzei, MD, UNITED STATES Stephen A. Hunt, MD Kimberly V Tucker, MD, UNITED STATES Anthony Scillia, UNITED STATES Patrick A Armstrong, MD, UNITED STATES Mathew S Chow, MD, UNITED STATES Richard A Stennett, MD, UNITED STATES James C Wittig, MD
Efficacy Of Enoxaparin As A Thromboprophylactic Agent In Major Lower Limb Orthopedic Surgeries. ePoster Presentation Raghavendra Raju, MBBS,MS, INDIA Prasad Soraganvi, MBBS, MS, DNB, MRCS, SICOT-dip, INDIA
Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis Abstract Presentation 9 minutes Casey Wang, MD, CANADA Dan Cohen, MD, CANADA Jeffrey Kay, MD, CANADA Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Carlomagno Cardenas-Nylander, MD, SPAIN Anil S. Ranawat, MD, UNITED STATES Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA
Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged? Abstract Presentation 5 minutes Gen Lin Foo, MD, SINGAPORE Catherine J. Bacon, PhD, MSc, BSc, BPhed(Hons), NEW ZEALAND Matthew J. Brick, MBChB, FRACS, NEW ZEALAND

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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