Modified Loop Suture Technique in Arthroscopic Labral Repair of the Hip
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PROVIDER: S-EPMC10533857 | biostudies-literature | 2023 Aug
REPOSITORIES: biostudies-literature
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Project description:Arthroscopic hip labral repair has beneficial short-term outcomes; however, debate exists regarding ideal surgical labral repair technique. This technical note presents an arthroscopic repair technique that uses intrasubstance labral suture passage to restore the chondrolabral interface. This "Iberian suture technique" allows for an anatomic repair while posing minimal risk of damage to the labral and chondral tissues.
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Project description:The normal labrum is crucial to the biomechanical function of the hip joint, not only increasing the surface area and depth of the acetabulum but also maintaining a suction seal to assist in normal synovial fluid flow from the peripheral to the central compartment. Simple loop suture repairs of the labrum may evert the labrum, thus losing the optimal seal, as well as causing abrasion of the articular cartilage. Vertical mattress suture and labral base fixation techniques aim to leave the free edge of the labrum intact and undisturbed, therefore improving the contact of the labrum to the femoral head and neck to improve the seal of the acetabulum. We aim to describe a double-stranded single-pass vertical mattress suture technique that may allow greater versatility to the surgeon in repairing thinner labrums while still achieving a free and continuous free edge.
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Project description:Labral tears in the hip may cause painful clicking or locking of the hip, reduced range of motion, and disruption to sports and daily activities. The acetabular labrum aids stabilization of the hip joint, particularly during hip motion. The fibrocartilaginous structure extends the acetabular rim and provides a suction seal around the femoroacetabular interface. Treatment options for labral tears include debridement, repair, and reconstruction. Repair of the labrum has been shown to have better results than debridement. Labral refixation is achieved with sutures anchored into the acetabular rim. The acetabular rim is trimmed either to correct pincer impingement or to provide a bleeding bed to improve healing. Labral repair has shown excellent short-term to midterm outcomes and allows patients to return to activities and sports. Arthroscopic rim trimming and labral refixation comprise an effective treatment for labral tears with an underlying diagnosis of femoroacetabular impingement and are supported by the peer-reviewed literature.
| S-EPMC3716192 | biostudies-literature
Project description:Os acetabuli is thought to be the result of an unfused ossification center or an acetabular rim fracture in the setting of femoral-sided femoroacetabular impingement syndrome. Historically, patients with symptomatic hips have been treated with resection alone; however, in patients with large bone fragments or with reduced acetabular coverage prior to surgical intervention, iatrogenic dysplasia and structural instability may develop after resection. Therefore, for patients with an acetabular os, labral tearing, and cam-type femoroacetabular impingement, internal fixation of the os acetabuli, femoral osteochondroplasty, and labral repair have been described. We propose a "suture-on-screw" arthroscopic technique to simultaneously address both the labral tear and os acetabuli, thereby reducing the number of suture anchors required for labral fixation, leading to an efficient and cost-effective approach for the treatment of these patients.
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Project description:Preservation of hip labral function is a primary goal in hip preservation surgery. Arthroscopic labral reconstruction in the hip is an alternative procedure for irreparable labrum in the nonarthritic hip population, with beneficial outcomes reported. Several challenges occur during labral reconstruction that make the procedure more difficult. The first is measuring the labral defect and matching the graft perfectly to the patient. The second is subsequent suture fixation and passage around the graft when it is loose within the joint. We propose a modification to the pull-through technique that both eliminates the inaccuracies in graft measurement and minimizes graft damage by eliminating the step of suture passage around the graft. This technique can be used for both segmental reconstruction or circumferential reconstruction of the hip labrum and can also accommodate knotless and knot-tied anchors. The advantages of this technique are increased procedure accuracy and efficiency.
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| S-EPMC10837843 | biostudies-literature
Project description:With advancements in arthroscopic surgery, arthroscopic biceps tenodesis with suture anchor recently has been reported to be a reasonable option for the treatment of biceps pathologies, especially for those that are symptomatic or accompanied by a rotator cuff tear. We introduce our technique of arthroscopic biceps tenodesis with suture anchor that we call the loop-suture technique, which is constructed with 1 loop strand and another sutured strand. This technique can help to improve biceps grip and simultaneously minimize longitudinal splitting of the tendon. In addition, it is relatively simple and can be performed with the use of conventional devices and arthroscopic portals used for rotator cuff repair, without the formation of additional portals or a separate incision for the tenodesis.
| S-EPMC3716208 | biostudies-literature
Project description:The importance of the acetabular labrum has been well documented for the function and overall health of the hip joint. Several biomechanical studies have shown the sealing effect of the acetabular labrum. In the past decade, labral repair procedures have gained increased attention, with the literature suggesting that the outcomes after hip arthroscopy are directly related to labral preservation. However, a primary labral repair can be challenging in cases of hypoplastic, ossified, or complex and irreparable labral tears in which there is insufficient tissue to perform a primary repair. For these cases, labral reconstruction becomes a viable option with good outcomes at short-term and midterm follow-up. A subset of these patients may show viable remnants of the labral circumferential fibers but, because of the low tissue volume, these remnant fibers are unable to maintain the suction seal. In this situation, a labral augmentation may be a viable alternative to labral reconstruction while preserving as much native labral tissue as possible. The purpose of this Technical Note is to describe an arthroscopic hip labral augmentation technique using iliotibial band autograft or allograft.
| S-EPMC5442390 | biostudies-literature
Project description:The goal of acetabular labral repair is to preserve/restore labral function. Maintaining labral function necessitates recreating the labrum's anatomy, especially avoiding a nonanatomic repair of the labrum to the acetabular rim. The purpose of this report is to detail the technique of acetabular labral repair using this Q-FIX all-suture anchor.
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