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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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Covid Mortality Among Neck Of Femur Fractures During The Pandemic 2019 Abstract Presentation 5 minutes Aashish Raghu, MBBS, MS, MRCS, FRCS (Tr & Orth), UNITED KINGDOM Anas Hassan, MBBS, MRCS, UNITED KINGDOM Nicholas Dr Roeck, MB ChB, FRCS (ENG), FRCS (Tr&Orth), UNITED KINGDOM Mohamed Antar, MBBS, Master of Orthopaedics, MRCS, UNITED KINGDOM
Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Panagiota Vlaserou, BSc in Physiotherapy, MSc Biomedical Engineer, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Ioannis K. Antonopoulos, GREECE Vassilis N. Psychoyios, MD, GREECE Theodoros G. Troupis, Prof, GREECE
Outcomes Of Revision Hip Arthroscopy Are Unaffected By Intraoperative Findings: A Matched Cohort Study ePoster Presentation Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
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
The Relationship Between Early And Mid-Term Hip Arthroscopy Outcomes: Employing 3 Month Follow-Up To Predict Mid-Term Results Abstract Presentation 5 minutes Mario Hevesi, MD, PhD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Benjamin G. Domb, MD, UNITED STATES Aaron J. Krych, 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
Outcomes of Proximal Hamstring Tendon Repair in Patients Older than 50 Years of Age Abstract Presentation 5 minutes Alexander Rainer Manuel Bitzer, MD, UNITED STATES Daniel Hurwit, UNITED STATES Julian Joseph Sonnenfeld, MD, UNITED STATES Durham Weeks, MD, UNITED STATES
Radiographic Indices Are Not Predictive Of Clinical Outcome Among 1,735 Patients Indicated For Hip Arthroscopy: A Machine Learning Analysis Abstract Presentation 5 minutes Prem N Ramkumar, MD, MBA, UNITED STATES Jaret M Karnuta, MS, UNITED STATES Heather S Haeberle, MD, UNITED STATES Spencer Sullivan, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Benedict U. Nwachukwu, MD, MBA, 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
Health Literacy in Periacetabular Osteotomy Procedure: A Quantitative Assessment of the Readability, Understandability and Actionability of Online Patient Education Material ePoster Presentation Alan Shamrock, MD, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Burke Gao, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Robert W. Westermann, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES
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
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
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
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
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
Traumatic Hip Dislocations In The Pediatric Patient: Injury Patterns, Need For Axial Imaging, Outcomes, And Selective Hip Arthroscopy Abstract Presentation 5 minutes Cliff Willimon, MD, UNITED STATES Anthony Egger, MD, UNITED STATES Crystal A. Perkins, 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