Labral repair

Hip acetabular labrum plays a chondroprotective role by maintaining stability, providing a suction seal, and contributing to load distribution. In symptomatic patients without osteoarthritis, arthroscopic labral repair has strong clinical and biomechanical data to support its use. For irreparable tears, the labrum should be reconstructed. Biomechanically, labral reconstruction does not demonstrate superiority when compared to labral repair or the intact native labrum state. However, it is superior to labral excision...

Not all acetabular labral tears, tissue quality, and size are the same. There is still a role for selective debridement of the acetabular labrum when stable, functional labral tissue remains. An unstable labrum that appears very different than the rest of the labrum is an easy target for repair. Tears requiring resection require graft augmentation or reconstruction.

BACKGROUND: Quantitative analysis of the glenoid face knotless-type anchor placement for arthroscopic Bankart repair has not been reported. PURPOSE: To evaluate the clinical and radiologic outcomes after arthroscopic Bankart repair using knotless bioabsorbable anchors depending on the anchor location. STUDY DESIGN: Case series, Level of evidence, 4. METHODS: A total of 124 patients (113 men and 11 women; age, 25.6 ± 7...

Gluteus medius and minimus tendon pathology is a common cause of lateral hip pain. In patients that are dissatisfied with their hip condition following non-surgical treatment, gluteal repair has demonstrated excellent short-, mid-, and now recently, long-term subjective patient-reported and objective clinician-measured outcomes. In patients with peritrochanteric hip pain, the proportion of their overall hip pain may be influenced by the hip joint due to conditions like Femoroacetabular Impingement Syndrome (FAIS), acetabular dysplasia, labral tears, and arthritis...

HYPOTHESIS/PURPOSE: The purpose of this study was to compare PROMs in patients undergoing anterior glenoid labral repair using all-suture versus conventional anchors. We hypothesized PROMs would be similar between groups. METHODS: We performed a retrospective review of the Arthrex Global Surgical Outcomes System (SOS) database, querying patients who underwent arthroscopic glenoid labral repair between 01/01/2015 and 12/31/2020. Patients aged 18-100, who had isolated glenoid labrum repair with at least 12-month follow-up were included...

In the setting of femoroacetabular impingement of the hip joint, paralabral cysts are well-documented sequelae. These cysts are typically associated with labral tears caused by CAM and/or pincer-type bony lesions. Synovial fluid extravasation through a tear in the labrum, similar to a popliteus cyst, leads to formation of a capsular-based cyst that is usually self-limiting. Few documented cases of these cysts causing compression of nearby neurovascular structures exist. There are several studies documenting arthroscopic decompression of these cysts, but none reporting compression of the femoral vein by a paralabral cyst resulting in deep vein thrombosis...

BACKGROUND: Numerous studies indicate that glenoid bony augmentation raises the risk of complications during and after surgery. On the other hand, repairing the labrum alone in cases with subcritical glenoid bone loss results in recurrent instability and persistent apprehension. As a result, recent advancements in shoulder instability surgery prioritize fully restoring the anterior shoulder restraint. OPERATIVE TECHNIQUE: A novel method for treating recurrent anterior shoulder instability with subcritical glenoid bone loss and off-track Hill-Sachs lesion in skeletally immature patients is suggested: the use of dynamic anterior stabilization technique incorporating the long head of the biceps tendon onto the anterior glenoid rim via trans-subscapular transfer, in conjunction with Hill-Sachs remplissage...

INTRODUCTION: Posterior shoulder instability and consequent labral tear have been predominantly associated with retroversion of the bony glenoid and chondrolabral version. However, literature concerning the degree of glenoid and chondrolabral version and clinical outcomes following labral repair is scarce. METHODS: A retrospective cohort study was undertaken among patients with posterior shoulder instability who had undergone arthroscopic isolated posterior labral repair...

Several arthroscopic techniques to treat anterior shoulder instability have been described. Bankart repair may be insufficient in cases with some degree of bone loss, and arthroscopic Latarjet is technically challenging. It is not rare to find at the time of surgery a more extensive labral tear (SLAP lesion) or an insufficient anterior capsulolabral tissue. We describe for those cases a dynamic anterior stabilization where using the long head of the biceps we are treating the SLAP lesion and at the same time it provides the "sling effect" of a Latarjet procedure for the anterior instability...

BACKGROUND: The severity of degenerative changes of the hip is known to adversely impact the outcomes of the treatment of femoroacetabular impingement (FAI). Although the operative indications for FAI have expanded to include patients with moderate degrees of hip osteoarthritis, the exact stage of hip osteoarthritis at which surgery for FAI can offer clinical benefits is still uncertain. QUESTIONS/PURPOSES: (1) How does the survivorship free from conversion to THA and survivorship free from revision differ between patients with preexisting Tönnis Grades 2 or 3 changes and those without advanced degenerative changes (Tönnis Grade 0 or 1) after mini-open femoroacetabular osteoplasty? (2) What are the differences in hip-specific and general-health outcome scores between the two groups after mini-open femoroacetabular osteoplasty? METHODS: From December 2003 to April 2019, we treated 901 patients for FAI, and their clinical data were systematically recorded in a longitudinally maintained database...

BACKGROUND: Complex regional pain syndrome is a neuropathic pain disorder associated with ongoing pain that persists beyond the usual expected tissue healing time and that is disproportionate to the degree of tissue injury present. Complex regional pain syndrome after hip arthroscopy has not been reported before. Hip arthroscopy is a fast-growing domain that could lead to an increasing number of complex regional pain syndrome cases, probably owing to the high traction forces that are necessary...

BACKGROUND: Posterior glenohumeral instability is an increasingly recognized cause of shoulder pain and dysfunction among young, active populations. Outcomes after posterior stabilization procedures are commonly assessed using patient-reported outcome measures including the Single Assessment Numeric Evaluation (SANE), the Rowe instability score, the American Shoulder and Elbow Surgeons (ASES) score, and the visual analog scale (VAS) for pain. The clinical significance thresholds for these measures after arthroscopic posterior labral repair (aPLR), however, remain undefined...

BACKGROUND: Hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) has proven to be an effective surgical intervention, with high rates of return to sport and work as well as favorable outcomes at short- and midterm follow-up. However, limited data exist on outcomes at long-term follow-up. PURPOSE: To evaluate patient-reported outcomes (PROs) at a minimum 10-year follow-up after primary hip arthroscopic surgery including labral repair, femoral osteochondroplasty, acetabular osteochondroplasty, and capsular closure for FAIS...

BACKGROUND: There is scarce literature on clinically significant values after arthroscopic Bankart repair (ABR). PURPOSE: To determine the minimal clinically important difference (MCID) and the patient acceptable symptom state (PASS) thresholds at 1 year for the Rowe and Athletic Shoulder Outcome Scoring System (ASOSS) scores after ABR and to determine the effect of patient characteristics on these metrics after ABR. STUDY DESIGN: Case series; Level of evidence, 4...

BACKGROUND: The gold-standard surgical management for superior labral anterior to posterior (SLAP) lesions is unclear. This meta-analysis compares the outcomes of different surgical SLAP lesion management techniques including labral repair, long head of biceps (LHB) tenodesis and LHB tenotomy with consideration to clinical scores, return to sports, re-operation, range-of-motion and patient satisfaction. METHODS: PRISMA guidelines were adhered. Web of Science, PubMed, Cochrane Central, Science direct and EMBASE were searched using relevant keywords...

PURPOSE: The purpose is to assess the diagnostic accuracy of a provocative test coined as the 'posterior compression test' (PCT) in those with the suspected posterior labral tear or lesion. METHODS: A total of 515 'arthroscopic labral repairs' were identified between April 2013 and September 2020. Excluding those with concomitant shoulder pathologies, and only including those with pre-operative documentation of the PCT and/or the Jerk test, 191 patients were included...

PURPOSE: To compare clinical failure, recurrent instability, patient-reported outcome measures (PROMs), and return to sport (RTS) between knotted and knotless fixation methods in arthroscopic posterior labral repair for isolated posterior shoulder instability (PSI). METHODS: Multiple databases were queried according to Preferred Reported Items for Systematic Reviews and Meta-Analyses guidelines for clinical studies with Level I to IV evidence, including knotted and knotless suture anchors for arthroscopic posterior labral repair...

There is a large debate revolving around the optimal surgical management of hip labral tears. Currently, the literature tends to gravitate toward labral repair as the mainstay of treatment, followed by labral reconstruction when repair is not feasible. Some studies assert that there is no difference between labral repair versus debridement, whereas others support repair. Other studies support labral reconstruction. In the end, it is the quality of the cartilage that may be most important. Intra-articular cartilage damage is more important than the labral treatment method when it comes to hip arthroscopy long-term outcomes...

Posterior labral tears occur more often than imagined 25 years ago. Although such tears are generally identified in patients with posterior shoulder instability, the spectrum of labral tears in patients without instability creates a challenging diagnosis. Both physical examination and magnetic resonance imaging interpretation are difficult. Pathology encompassing posterior labral tears without instability notably reveals differences compared with throwers with posterior labral tears and patients with posterior instability...

Posterior shoulder instability is of particular therapeutic interest, as it typically affects patients with high functional demands such as young athletes and active adults. Although posterior capsulolabral repair has high return-to-sport rates, it is associated with recurrent instability of up to 11%. Posterior glenoid bone loss and significant glenoid retroversion have been identified as risk factors for recurrent instability and failure after primary arthroscopic soft-tissue repair. Therefore, posterior glenoid bone block reconstruction may be indicated for glenoid bone loss 20% or greater (as measured by the perfect circle technique) or greater than 10% in the setting of pathologic glenoid, failed primary posterior labral repair, incompetent posterior capsular tissue, or significant risk factors for failure of soft-tissue repair...