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Hip Labrum Reconstruction With A Polyurethane Scaffold: A Preliminary Report Of 3 Cases


Bruno Capurro, MD, PhD.
SPAIN

Hip Labrum Reconstruction With A Polyurethane Scaffold: A Preliminary Report Of 3 Cases

Bruno Capurro, MD, PhD., SPAIN Marc Tey, MD, PhD., SPAIN Raul Torres, MD, SPAIN Fernando Marques, MD, PhD., SPAIN Alfonso León, MD, PhD., SPAIN Oliver Marín-Peña, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN

Hospital del Mar - Universidad Autónoma de Barcelona, Barcelona, SPAIN

2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Labrum

Diagnosis / Condition

Impingement

Treatment / Technique

Repair / Reconstruction

Patient Populations

Sport Specific Population

Diagnosis Method

X-ray MRI

Sports Medicine

Outcome Studies

Labrum

Labrum Treatment

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Summary: Reconstruction or augmentation of segmental labral defect with a polyurethane scaffold may be an effective procedure. At 4 years after implantation, our small cases series resulted in improved hip joint function, reduced pain, and scaffold preservation on follow-up imaging.

Background

Surgical treatment of labral injuries has shifted from debridement to preservation surgery over the past decades. Primary repair and secondary reconstruction techniques are aimed at restoring the labral seal and preserving or improving contact mechanics. Non-repairable tears require either augmentation or reconstruction with auto- or allografts. As an alternative to procedures using human tissues, we present our initial experience using a synthetic, off-the-shelf polyurethane scaffold for reconstruction of segmental labral tissue loss in femoroacetabular impingement.

Methods

Three patients aged 37-44 (2 male, 1 female) were included in this series. Labral reconstruction (1 case) and augmentation (2 cases) were performed using a synthetic polyurethane scaffold developed for meniscal substitution (Actifit?, Orteq Ltd, London, UK) and adapted to the hip in 1 pincer, 1 cam and 1 mixed lesion. Clinical results were analysed with patient reported outcomes (PROMs) using the Non-Arthritic Hip Score (NAHS) and the Daily Live Activities Hip Outcome Score (DLA HOS), and Magnetic Resonance Images (MRI) at two- and four-years follow-up.

Results

Clinically relevant improvement was seen in all PROMs at 4 years. The NAHS scores improved from an average of 57.7 to 82.3 (50.9% improvement) and the HOS from 59 to 79.3 (35.3% improvement). Last follow-up MRIs confirmed the presence of the scaffold, however the scaffold signal was not equal to the native labrum. There was no shrinkage in any scaffold and no progression to hip osteoarthritis seen on the 2-year or the 4-year MRIs.

Conclusion

Reconstruction or augmentation of segmental labral defect with a polyurethane scaffold may be an effective procedure. At 4 years after implantation, our small cases series resulted in improved hip joint function, reduced pain, and scaffold preservation on follow-up imaging.

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