Arthroscopic Treatment of Hip Dislocation After Previous Hip Arthroscopy: Capsular Reconstruction With Labral Augmentation
| Autor: | Shane J. Nho, Alexander Newhouse, Jorge Chahla, Stephanie E. Wong |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Orthopedic surgery
musculoskeletal diseases 030222 orthopedics medicine.medical_specialty Labrum Acetabular labrum business.industry 030229 sport sciences Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Technical Note medicine Orthopedics and Sports Medicine Hip arthroscopy business RD701-811 |
| Zdroj: | Arthroscopy Techniques Arthroscopy Techniques, Vol 10, Iss 3, Pp e867-e872 (2021) |
| ISSN: | 2212-6287 |
| Popis: | The hip capsule and acetabular labrum are critical structures that function to protect and stabilize the hip joint. As the use of hip arthroscopy increases, there is increasing interest in the integrity of the hip capsule and labrum in optimizing postoperative function and outcomes. In this report, we describe the surgical technique for capsular reconstruction with dermal allograft and labral augmentation with tibialis anterior allograft for the treatment of gross instability after hip arthroscopy. This technique may be applied in situations with large capsular defects and deficient labral tissue. Technique Video Video 1 Intraoperative assessment of the central compartment revealed labral insufficiency with residual femoroacetabular impingement syndrome pathology. Viewing from the MMAP, the first suture anchor is placed at the 10-o’clock position via the AL portal. The suture from the suture anchor is used to measure the length of labral insufficiency, which was 4.2 cm. The remaining 3 suture anchors are placed up to the 4-o’clock position through the DALA portal. Two double-loaded suture anchors are placed adjacent to the head of the rectus femoris tendon along the acetabulum for capsular reconstruction. The labral allograft is passed through the DALA portal using the Kite technique and knotted down anteromedially to posterolaterally. Upon plication of the vertical limb of the capsulotomy, a 2.0 × 2.5-cm defect remained. Sutures from the double-loaded anchors are passed through the distal lateral and distal medial T-capsulotomy leaflets in a mattress fashion and knotted. One suture from the proximal anchor and one suture from the distal anchor is retrieved through the DALA portal and passed through the proximal and distal corners of the capsular allograft, respectively. The graft is then shuttled through the DALA portal using the Kite technique and each corner is knotted down in a simple fashion. A dynamic examination is then performed to evaluate graft placement. (AL, anterolateral; DALA, distal anterior lateral accessory; MMAP, modified mid-anterior portal.) |
| Databáze: | OpenAIRE |
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