Remplissage and Labral Reconstruction Technique Correlated With Dynamic Hip Examination Using the Kite Technique for Restoration of the Suction Seal in Revision Hip Arthroscopy

Overview

Journal Arthrosc Tech

Publisher Elsevier

Date 2021 Aug 17

PMID 34401245

Citations 2

Authors

Safa Gursoy

Amar S Vadhera

Harsh Singh

Allison K Perry

Shane J Nho

Jorge Chahla

Affiliations

Soon will be listed here.

Abstract

The hip suction seal plays a key role in distractive stability and maintenance of intra-articular fluid pressure of the hip. Preservation of the suction seal relies on the acetabular labrum and the congruence between the labrum and the femoral head-neck junction. During the treatment of cam-type impingement, iatrogenic over-resection in the femoral head-neck junction or labrum deficiency can cause loss of this suction seal. In this technical note, we describe a remplissage procedure performed in addition to labral reconstruction in a patient with loss of the suction seal due to a dysfunctional labrum and previous over-resection of a cam deformity.

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References

Notzli H, Wyss T, Stoecklin C, Schmid M, Treiber K, Hodler J . The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002; 84(4):556-60. DOI: 10.1302/0301-620x.84b4.12014. View

Fagotti L, Kemler B, Utsunomiya H, Storaci H, Krob J, Brady A . Effects of Capsular Reconstruction With an Iliotibial Band Allograft on Distractive Stability of the Hip Joint: A Biomechanical Study. Am J Sports Med. 2018; 46(14):3429-3436. DOI: 10.1177/0363546518802841. View

Frank J, Chahla J, Mitchell J, Soares E, Philippon M . Remplissage of the Femoral Head-Neck Junction in Revision Hip Arthroscopy: A Technique to Correct Excessive Cam Resection. Arthrosc Tech. 2017; 5(6):e1209-e1213. PMC: 5263060. DOI: 10.1016/j.eats.2016.07.012. View

Mansor Y, Perets I, Close M, Mu B, Domb B . In Search of the Spherical Femoroplasty: Cam Overresection Leads to Inferior Functional Scores Before and After Revision Hip Arthroscopic Surgery. Am J Sports Med. 2018; 46(9):2061-2071. DOI: 10.1177/0363546518779064. View

Vaughn Z, Safran M . Arthroscopic femoral osteoplasty/chielectomy for cam-type femoroacetabular impingement in the athlete. Sports Med Arthrosc Rev. 2010; 18(2):90-9. DOI: 10.1097/JSA.0b013e3181dfce63. View

Shapira J, Kyin C, Go C, Rosinsky P, Maldonado D, Lall A . Indications and Outcomes of Secondary Hip Procedures After Failed Hip Arthroscopy: A Systematic Review. Arthroscopy. 2020; 36(7):1992-2007. DOI: 10.1016/j.arthro.2020.02.028. View

Cadet E, Chan A, Vorys G, Gardner T, Yin B . Investigation of the preservation of the fluid seal effect in the repaired, partially resected, and reconstructed acetabular labrum in a cadaveric hip model. Am J Sports Med. 2012; 40(10):2218-23. DOI: 10.1177/0363546512457645. View

Bhatia S, Chahla J, Dean C, Ellman M . Hip Labral Reconstruction: The "Kite Technique" for Improved Efficiency and Graft Control. Arthrosc Tech. 2016; 5(2):e337-42. PMC: 4912620. DOI: 10.1016/j.eats.2016.01.005. View

Suppauksorn S, Beck E, Chahla J, Cancienne J, Krivicich L, Rasio J . Comparison of Suction Seal and Contact Pressures Between 270° Labral Reconstruction, Labral Repair, and the Intact Labrum. Arthroscopy. 2020; 36(9):2433-2442. DOI: 10.1016/j.arthro.2020.05.024. View

10.

Philippon M, Nepple J, Campbell K, Dornan G, Jansson K, LaPrade R . The hip fluid seal--Part I: the effect of an acetabular labral tear, repair, resection, and reconstruction on hip fluid pressurization. Knee Surg Sports Traumatol Arthrosc. 2014; 22(4):722-9. DOI: 10.1007/s00167-014-2874-z. View

11.

Crawford M, Dy C, Alexander J, Thompson M, Schroder S, Vega C . The 2007 Frank Stinchfield Award. The biomechanics of the hip labrum and the stability of the hip. Clin Orthop Relat Res. 2007; 465:16-22. DOI: 10.1097/BLO.0b013e31815b181f. View

12.

Malviya A, Raza A, Jameson S, James P, Reed M, Partington P . Complications and survival analyses of hip arthroscopies performed in the national health service in England: a review of 6,395 cases. Arthroscopy. 2015; 31(5):836-42. DOI: 10.1016/j.arthro.2014.12.013. View

13.

Hoppe D, de Sa D, Simunovic N, Bhandari M, Safran M, Larson C . The learning curve for hip arthroscopy: a systematic review. Arthroscopy. 2014; 30(3):389-97. DOI: 10.1016/j.arthro.2013.11.012. View

14.

Nepple J, Philippon M, Campbell K, Dornan G, Jansson K, LaPrade R . The hip fluid seal--Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction. Knee Surg Sports Traumatol Arthrosc. 2014; 22(4):730-6. DOI: 10.1007/s00167-014-2875-y. View

15.

Cvetanovich G, Harris J, Erickson B, Bach Jr B, Bush-Joseph C, Nho S . Revision Hip Arthroscopy: A Systematic Review of Diagnoses, Operative Findings, and Outcomes. Arthroscopy. 2015; 31(7):1382-90. DOI: 10.1016/j.arthro.2014.12.027. View

16.

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock K . Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003; (417):112-20. DOI: 10.1097/01.blo.0000096804.78689.c2. View

17.

Dwyer M, Jones H, Hogan M, Field R, McCarthy J, Noble P . The acetabular labrum regulates fluid circulation of the hip joint during functional activities. Am J Sports Med. 2014; 42(4):812-9. DOI: 10.1177/0363546514522395. View