Labral reconstruction

Originally described in 2009[1] using the ligamentum teres capitis, arthroscopic labral reconstruction using a variety of graft tissue has demonstrated promising short and mid-term clinical outcomes.

[7] The labrum, when damaged, is also a pain generator, due to a large concentration of type II pain-associated free nerve endings found throughout the tissue, most pronounced at the labral base.

Since then, surgeons have reported on a variety of graft choices and surgical techniques, and an arthroscopic approach has usurped open dislocation, due to fewer complications, a lower need for revision surgery and quicker recovery time.

[5] It is most often utilized in order to surgically correct the damage resulting from femoroacetabular impingement (FAI), a condition in which the femoral head articulates imperfectly with the acetabular cup.

A recent multicenter epidemiological study found that the majority of patients undergoing labral reconstruction are middle-aged females whose pain is localized around the groin.

Brian White and Andrew Wolff, two sports medicine trained surgeons specializing in hip arthroscopy, both prefer the utilization of allograft tissue.

[12] There was also concern that despite resection of the visibly damaged tissue there existed the possibility for underresection, which could lead to persistent pain despite restoration of the labral biomechanics.

[12] This technique has shown promising outcomes when utilized in patients whose native labral tissue is far too damaged for repair or debridement.

A new postless table designed by Stryker has nearly eliminated the risk of postoperative saddle parasthesia, which was previously a common complication.

Post-operative deep-vein thrombosis is also possible, but the rate of this complication can be minimized through the use of blood thinning medications and early ambulation.

Gray342.png
Hip joint, front view. The capsular ligament has been largely removed.
Diagram illustrating the two subtypes of FAI.