Carlos Tobar, Jose Tomas Bravo, Gonzalo Escobar and Dante Parodi*

Department of Orthopaedics, REDSALUD Chile, Chile

*Corresponding Author:Dante Parodi, Department of Orthopaedics, REDSALUD Chile, Chile.

Received: May 20, 2022; Published: June 13, 2022

Abstract

Introduction: Labral injury repair has been a matter of interest in hip preservation surgery. Multiples fixations methods using anchors have been described. A single labral perforation avoids the loss of the sealing and decreases labral tear risk, whereas a double-loop technique avoids shearing the labrum. Nevertheless, it is still unclear what the best method is to perform the repair.

Objective: We present a technique for fixation of double-loop labral repair, having a unique enter labral site and performed through a single gate, providing joint sealing, resistance to pull out, and lack of eversion or labrum stenosis.

Surgical Technique: By classic anterolateral and a modified anterior portal, minimal capsulotomy is performed with the preservation of an interportal bridge. Superficial drilling of the acetabular rim is performed with a 5.5mm arthroscopic circular burr. Through an 8.5mm cannula, the anchor is placed in the acetabular rim. The suture pin is threaded with the strand, penetrating the labrum close to the chondrolabral junction or through it, creating a suture loop in the intra-articular space. The strand is released from the suture pin, which is removed, and re-entered through the intra-articular space, capturing the loop, and taking it to the extra-articular zone. The suture pin is re-inserted through the loop, and the strand is captured, which is slid through the loop and taken out of the cannula. The result is a double beam knot made with the working strand and the strand pole. The corresponding knots are made and slid according to the traditional technique.

Conclusion: Double-loop and single perforation give the surgeon versatility and capability of fixation in a broad spectrum of labral injuries, allowing a resolution by an arthroscopic standard, recovering the joint seal without any further complication, only limited by the proper set of the anchor and the tightness of the knot.

Keywords: Arthroscopic; Hip; Perforation; Double Loop

References

1. Safran M. “The Acetabular Labrum: Anatomic and Functional Characteristics and Rationale for Surgical Intervention”. American Academy of Orthopaedic Surgeon6 (2010): 338-345.
2. Beaulé P., et al. “Acetabular Labral Tears”. The Journal of Bone and Joint Surgery-American3 (2009): 701-710.
3. Briggs K., et al. “Prevalence of acetabular labral tears in asymptomatic young athletes”. British Journal of Sports Medicine4 (2017): 303.1-303.
4. Philippon M., et al. “The hip fluid sealdPart I: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip fluid pressurization”. Knee Surgery, Sports Traumatology, Arthroscopy 4 (2014): 722-729.
5. Philippon M., et al. “The hip fluid seal Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction”. Knee Surgery, Sports Traumatology, Arthroscopy 22 (2014): 730-736.
6. Moreira B., et al. “Eversion-Inversion Labral Repair and Reconstruction Technique for Optimal Suction Seal”. Arthroscopy Techniques6 (2015): e697-e700.
7. Domb BG and Botser IB. “Paper 30: Clinical results of arthro- scopic treatment of acetabular labral tears using three methods”. Arthroscopy 2 (2012): e60-e61.
8. Krych AJ., et al. “Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement: A prospective randomized study”. Arthroscopy 29 (2013): 46-53.
9. Chow R., et al. “Arthroscopic Labral Repair in the Treatment of Femoroacetabular Impingement”. Arthroscopy Techniques4 (2013): e333-e336.
10. Hernandez J and McGrath B. “Safe Angle for Suture Anchor Insertion During Acetabular Labral Repair”. Arthroscopy: The Journal of Arthroscopic and Related Surgery12 (2008): 1390-1394.
11. Stubbs A., et al. “Arthroscopic Hip Labral Repair: The Iberian Suture Technique”. Arthroscopy Techniques3 (2014): e351-e354.
12. Kelly B., et al. “Arthroscopic Labral Repair in the Hip: Surgical Technique and Review of the Literature”. Arthroscopy: The Journal of Arthroscopic and Related Surgery12 (2005): 1496-1504.
13. Türker M., et al. “Vascularity and histology of fetal labrum and chondrolabral junction: its relevance to chondrolabral detachment tears”. Knee Surgery, Sports Traumatology, Arthroscopy2 (2011): 381-386.
14. Cashin M., et al. “Embryology of the acetabular labral-chondral complex”. Journal of Bone and Joint Surgery - British 90-B.8 (2008): 1019-1024.
15. Klennert B., et al. “The mechanics of focal chondral defects in the hip”. Journal of Biomechanics 52 (2017): 31-37.

Citation

Citation: Dante Parodi., et al. “Arthroscopic Repair of Hip Labrum Using a Technique of Single Perforation and Double Loop".Acta Scientific Orthopaedics 5.7 (2022): 49-52.

Copyright

Copyright: © 2022 Dante Parodi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.