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Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair

Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES

Massachusetts General Hospital, Boston, MA, UNITED STATES

2021 Congress Abstract Presentation 5 minutes Not yet rated

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Labrum

Diagnosis / Condition

Tears

Treatment / Technique

Arthroscopy

Labrum

Labrum Tears

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Summary: Laser doppler flowmetry of blood flow to the acetabular labrum found no statistically significant difference before and after suture repair. Post- repair blood flow was relatively more preserved medial to the suture than lateral.

Introduction

To our knowledge, no study has evaluated the effects of suture placement on microvascular supply during hip arthroscopy. The purpose of this study was to examine the effects of labral repair on labral perfusion in vivo, using laser doppler flowmetry (LDF) to measure microvascular blood flow.

Methods

Patients undergoing arthroscopic repair of the acetabular labrum by a single surgeon were prospectively enrolled between June 2018 and March 2020. An LDF probe (Moor Instruments; Wilmington, DE) was used to measure microvascular blood flow flux, measured in perfusion units (PU). Up to 8 LDF measurements were taken for each patient: 1 recording before and after labral elevation from the acetabular rim; 2 recordings before and after tie down of the first suture (one medial and one lateral to the suture); and if multiple anchors were necessary to carry out the repair, 1 recording before and after tie down of the second suture lateral to this suture. Some measurements were unable to be recorded due to inability to locate a nearby blood vessel and/or time constraints during surgery.

Results

21 patients [13 (61.9%) males; 8 (38.1%) females] met study criteria. Measurements before and after labral elevation were collected for 12 patients (11 loop suture repairs vs. 1 vertical mattress repair). Prior to labral elevation, the mean (95% CI) blood flow was 87.79 (52.18, 123.4) PU, and after labral elevation, mean blood flow was 90.78 (58.68, 122.87) PU (p=0.892). Measurements before and after first suture tie down were collected for 15 patients (13 loop suture repairs vs. 2 vertical mattress repairs) lateral to the position of the suture. Mean blood flow at this position was 79.77 (42.39, 117.16) PU before suture tie down and 62.33 (43.58, 81.08) PU after suture tie down (p=0.379). Measurements before and after first suture tie down were collected for 11 patients (10 loop suture repairs vs. 1 vertical mattress repair) medial to the position of the suture. Mean blood flow at this position was 66.09 (9.73, 122.46) PU before suture tie down and 90.07 (30.06, 150.08) PU after suture tie down (p=0.524). Measurements before and after second suture tie down were collected for 7 patients (5 loop suture repairs vs. 2 vertical mattress repairs) lateral to the position of the second suture. Mean blood flow was 54.00 (35.26, 72.74) PU before tie down and 117.97 (-31.64, 267.58) PU after suture tie down (p=0.320). Post-repair blood flow was relatively more preserved medial to first suture placement [+23.98 (+2.47, +45.49) PU] than lateral to first suture placement [-17.45 (-48.27, +13.38) PU] (p=0.0371).

Discussion

There was no statistically significant difference in microvascular blood flow to the labrum after labral elevation from the acetabular rim, after first suture placement, or after second suture placement. This suggests that current labral repair techniques may not negatively affect labral perfusion. However, when directly comparing the change in LDF measurements medial and lateral to the site of first suture tie down, post-repair blood flow was found to be relatively more preserved medial than lateral to it.

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Alpha Angle More Useful Than Femoral Head-Neck Offset to Predict Intra-Articular Damage in Patients with FAI Undergoing Hip Arthroscopy Abstract Presentation 5 minutes Jacob Shapira, MD, UNITED STATES Jade S Owens, BS, UNITED STATES David R. Maldonado, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Bezalel Peskin, MD, ISRAEL Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
EVALUATION OF HIP ARTHROSCOPY IN ELITE ATHLETES WITHOUT HIP DYSPLASIA . OUR EXPERIENCE. A 15-YEAR STUDY ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Ioannis K. Antonopoulos, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Demetrios P. Tsikouris, PT, GREECE Eleftherios Tsikouris, BSc in Physiotherapy, GREECE Theodoros G. Troupis, Prof, GREECE
Superior Outcomes With Routine Capsular Repair In Hip Arthroscopy Abstract Presentation 5 minutes Austin M Looney, MD, UNITED STATES Spencer M Comfort, BS, UNITED STATES Patrick T Connolly, BS, UNITED STATES Julia E McCann, MD, UNITED STATES Andrew Curley, MD, UNITED STATES William F. Postma, MD, UNITED STATES
Sex- And Age-Based Differences In Outcomes And Survivorship Following Primary Hip Arthroscopy At Short And Mid-Term Follow-Up: A Comparative Analysis ePoster Presentation David R. Maldonado, MD, UNITED STATES Jade S Owens, BS, UNITED STATES Cammille Go, BA, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Surgical Treatment of High-Grade Acute Intramuscular Hamstring Tendon Injuries in Athletes ePoster Presentation Randeep Singh Aujla, MBChB ChM FRCS (Tr&Orth) MFSEM, UNITED KINGDOM Steven Cecchi, BSc (Hons), MBBS, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA Peter T. Annear, FRACS(Orth), AUSTRALIA
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
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, 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
Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
The Surgeon Mentor Program: Outcomes of Total Hip Arthroplasty via the Direct Anterior Approach ePoster Presentation Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, AUSTRALIA Melinda Jiang, MD, AUSTRALIA Mark Inglis, FRACS BMBS B Med Sci FOrthoA, AUSTRALIA David Morris, MD, AUSTRALIA Nathan Eardley-Harris , MBBS, MClinSc, AUSTRALIA
A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post ePoster Presentation Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES Anthony Scillia, UNITED STATES
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
Midterm Outcomes Following Hip Labral Augmentation Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Rui Soares, BS, UNITED STATES Justin W. Arner, MD, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Maitland Martin, BS, UNITED STATES Spencer M Comfort, BS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA Abstract Presentation 5 minutes Kelsi Greenwood, BScHons, SOUTH AFRICA Jurek R. T. Pietrzak, MBBCh, FCS(SA)Orth, UNITED KINGDOM Zia Maharaj, MBChB(Pret), SOUTH AFRICA Josip N. Cakic, MD, PhD, FCS(SA)Orth, MMed(Orth)WITS, SOUTH AFRICA
The Effect Of Osteochondroplasty On Time To Reoperation After Arthroscopic Management Of Femoroacetabular Impingement Abstract Presentation 5 minutes Jeffrey Kay, MD, CANADA Nicole Simunovic, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Arthroscopy For Gunshot Wounds To The Hip ePoster Presentation Jorge Figueras, BS, UNITED STATES J P Ertl, MD, UNITED STATES Karchi Ertl, BS, UNITED STATES Brian Mullis, MD
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

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Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair

Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair

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Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair

Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair

Introduction

Methods

Results

Discussion

More ISAKOS 2021: Global Content