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Arthroscopic labral reconstruction with gracilis autograft.

ABSTRACT: Despite growing interest in hip arthroscopy and labral preservation, some patients have severely damaged, degenerative, or deficient labrums and may be candidates for arthroscopic labral reconstruction. The ligamentum teres has been used as a graft source for open hip labral grafting, and the iliotibial band has been used in the arthroscopic setting. We present an alternative method of hip labral reconstruction using the gracilis autograft, which does not require post-harvest manipulation. Arthroscopic techniques for graft tensioning and labrum-graft overlap are introduced that may facilitate restoration of labral function in patients with otherwise non-salvageable labrums.

SUBMITTER: Matsuda DK

PROVIDER: S-EPMC3678657 | biostudies-literature | 2012 Sep

REPOSITORIES: biostudies-literature

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Arthroscopic labral reconstruction with gracilis autograft.

Matsuda Dean K DK

Arthroscopy techniques 20120223 1

Despite growing interest in hip arthroscopy and labral preservation, some patients have severely damaged, degenerative, or deficient labrums and may be candidates for arthroscopic labral reconstruction. The ligamentum teres has been used as a graft source for open hip labral grafting, and the iliotibial band has been used in the arthroscopic setting. We present an alternative method of hip labral reconstruction using the gracilis autograft, which does not require post-harvest manipulation. Arthr ...[more]

PMID: 23766969

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Project description:BackgroundLabral reconstruction has been described as a solution for the irreparable labrum. Initial techniques employed autografts, while more recent procedures have utilized allografts. No study, to our knowledge, has compared graft types.PurposeTo compare outcomes between patients who underwent primary labral reconstruction with a hamstring allograft versus hamstring autograft.HypothesisNo significant differences in outcomes will be found between patients who underwent primary labral reconstruction with an allograft versus autograft.Study designCohort study; Level of evidence, 3.MethodsData from September 2010 to March 2015 were reviewed. Inclusion criteria were primary hip arthroscopic surgery with labral reconstruction using either a hamstring allograft (ALLO group) or autograft (AUTO group), with minimum 2-year follow-up scores for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Exclusion criteria were previous ipsilateral hip surgery, previous hip conditions, preoperative Tönnis osteoarthritis grade >1, and workers' compensation claims. Significance was set at P = .05.ResultsTwenty-nine patients (29 hips) were included (85.3% follow-up). There were 17 patients (17 hips) in the ALLO group and 12 patients (12 hips) in the AUTO group. All patient-reported outcome scores demonstrated significant improvements at latest follow-up except for the mHHS for the AUTO group (P = .064). Comparisons between the ALLO and AUTO groups at the preoperative and latest follow-up time points showed no significant differences (preoperative mean [range]: mHHS, 67.5 [33.0-100.0] and 65.8 [29.0-96.0], respectively [P = .826]; NAHS, 65.6 [26.3-92.5] and 58.5 [35.0-79.0], respectively [P = .322]; HOS-SSS, 43.7 [12.5-100.0] and 40.1 [19.0-78.0], respectively [P = .707]) (latest follow-up mean [range]: mHHS, 86.4 [56.0-100.0] and 81.4 [57.0-100.0], respectively [P = .46]; NAHS, 87.7 [60.0-100.0] and 82.4 [56.3-100.0], respectively [P = .396]; HOS-SSS, 81.7 [0.0-100.0] and 70.9 [27.8-100.0], respectively [P = .423]).ConclusionPrimary arthroscopic hip labral reconstruction yielded improvements in patient-reported outcome scores and high patient satisfaction. In this small series, no differences were found in clinical outcomes between hamstring allografts and autografts. Based on these results, hamstring allografts and autografts may be considered comparable graft choices for primary reconstruction. Because of the avoidance of donor site morbidity and the possible increase in patient satisfaction, allografts may be the preferred choice in a surgical setting when they are accessible.

Dataset Information

Arthroscopic labral reconstruction with gracilis autograft.

Publications

Arthroscopic labral reconstruction with gracilis autograft.

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