Arthroscopic Treatment of Femoroacetabular Impingement Using Labral Reconstruction with Capsular Autograft

ABSTRACT: The acetabular labrum is essential for stability during physiologic motion of the hip. Labral repairs frequently are attempted in cases of primary tears, although labral reconstruction is an important alternative in the revision setting or in the primary setting when the tissue is unsalvageable. Labral reconstruction has been shown to restore the hip’s suction-seal and fluid pressurization to that of the premorbid state, and cohort studies have demonstrated significantly improved patient-reported outcomes at midterm follow-up. Notably, the cost is of consideration during any reconstruction, and techniques have been described using both allograft and autograft sources. Autograft sources include the iliotibial band, ligamentum teres, gracilis tendon, and hip capsule. A previously described technique using the capsule was noted to hinder routine capsular closure. We present an alternative method for labral reconstruction using hip capsular tissue that is easily performed and allows for routine capsular closure. Technique Video Video 1 The patient is positioned supine in a lower-extremity traction table to undergo a right hip arthroscopy. An assessment of the central compartment and labral tissue is performed where it is determined that a labral reconstruction is indicated. Given the laxity of the capsular tissue, a capsular autograft is harvested longitudinally from the interportal capsulotomy for labral reconstruction. A traction stitch is placed in the capsulotomy to perform a complete femoral osteochondroplasty. A dynamic examination using fluoroscopy confirms complete resection of cam-type impingement. Labral reconstruction using capsular autograft is then performed along the areas of labral deficiency.

SUBMITTER: DeFroda S 

PROVIDER: S-EPMC8556663 | biostudies-literature |

REPOSITORIES: biostudies-literature