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Arthroscopic Management of Chondral and Labral Injuries

  • Alejandro Marquez-Lara
  • T. David Luo
  • Allston J. StubbsEmail author
Chapter

Abstract

Intra-articular hip injuries are a recognized cause of pain, mechanical symptoms, and disability in athletes. Traumatic intra-articular injury results from acute injury such as hyperabduction injuries, direct hip contact, and joint dislocation or subluxation. In contrast, atraumatic overuse injuries to the labrum and articular cartilage in the athlete’s hip result from repetitive motions exerted during sports (i.e., cutting, twisting, pivoting) and movements requiring supraphysiologic range of motion (i.e., ballet dancers, ice hockey goalies). Regardless of the origin, intra-articular hip injuries have a detrimental effect on athletes, typically reducing or eliminating their sports participation. The purpose of this chapter is to help guide surgeons and other health-care professionals in the arthroscopic management of chondral and labral injuries in the hip, with a particular focus on athletes.

Keywords

Hip Arthroscopy Chondral lesions Chondroplasty Microfracture Hip Labral tear Labral repair Labral reconstruction 

References

  1. 1.
    Domb BG, El Bitar YF, Lindner D, Jackson TJ, Stake CE. Arthroscopic hip surgery with a microfracture procedure of the hip: clinical outcomes with two-year follow-up. Hip Int. 2014;24(5):448–56.  https://doi.org/10.5301/hipint.5000144.CrossRefPubMedGoogle Scholar
  2. 2.
    McDonald JE, Herzog MM, Philippon MJ. Return to play after hip arthroscopy with microfracture in elite athletes. Arthroscopy. 2013;29(2):330–5.  https://doi.org/10.1016/j.arthro.2012.08.028.CrossRefPubMedGoogle Scholar
  3. 3.
    Kapron AL, Peters CL, Aoki SK, Beckmann JT, Erickson JA, Anderson MB, Pelt CE. The prevalence of radiographic findings of structural hip deformities in female collegiate athletes. Am J Sports Med. 2015;43(6):1324–30.  https://doi.org/10.1177/0363546515576908.CrossRefPubMedGoogle Scholar
  4. 4.
    Bhatia S, Nowak DD, Briggs KK, Patterson DC, Philippon MJ. Outerbridge grade IV cartilage lesions in the hip identified at arthroscopy. Arthroscopy. 2016;32(5):814–9.  https://doi.org/10.1016/j.arthro.2015.11.053.CrossRefPubMedGoogle Scholar
  5. 5.
    Schallmo MS, Fitzpatrick TH, Yancey HB, Marquez-Lara A, Luo TD, Stubbs AJ. Return-to-play and performance outcomes of professional athletes in North America after hip arthroscopy from 1999 to 2016. Am J Sports Med. 2018;46(8):1959–69.  https://doi.org/10.1177/0363546518773080.CrossRefPubMedGoogle Scholar
  6. 6.
    Marquez-Lara A, Mannava S, Howse EA, Stone AV, Stubbs AJ. Arthroscopic management of hip chondral defects: a systematic review of the literature. Arthroscopy. 2016;32(7):1435–43.  https://doi.org/10.1016/j.arthro.2016.01.058.CrossRefPubMedGoogle Scholar
  7. 7.
    Smith TO, Hilton G, Toms AP, Donell ST, Hing CB. The diagnostic accuracy of acetabular labral tears using magnetic resonance imaging and magnetic resonance arthrography: a meta-analysis. Eur Radiol. 2011;21(4):863–74.  https://doi.org/10.1007/s00330-010-1956-7.CrossRefPubMedGoogle Scholar
  8. 8.
    Mannava S, Howse EA, Stone AV, Stubbs AJ. Basic hip arthroscopy: supine patient positioning and dynamic fluoroscopic evaluation. Arthrosc Tech. 2015;4(4):e391–6.  https://doi.org/10.1016/j.eats.2015.05.005.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Howse EA, Botros DB, Mannava S, Stone AV, Stubbs AJ. Basic hip arthroscopy: anatomic establishment of arthroscopic portals without fluoroscopic guidance. Arthrosc Tech. 2016;5(2):e247–50.  https://doi.org/10.1016/j.eats.2015.12.003.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Stone AV, Howse EA, Mannava S, Miller BA, Botros D, Stubbs AJ. Basic hip arthroscopy: diagnostic hip arthroscopy. Arthrosc Tech. 2017;6(3):e699–704.  https://doi.org/10.1016/j.eats.2017.01.013.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Steadman JR, Miller BS, Karas SG, Schlegel TF, Briggs KK, Hawkins RJ. The microfracture technique in the treatment of full-thickness chondral lesions of the knee in National Football League players. J Knee Surg. 2003;16(2):83–6.PubMedGoogle Scholar
  12. 12.
    Korsmeier K, Classen T, Kamminga M, Rekowski J, Jager M, Landgraeber S. Arthroscopic three-dimensional autologous chondrocyte transplantation using spheroids for the treatment of full-thickness cartilage defects of the hip joint. Knee Surg Sports Traumatol Arthrosc. 2016;24(6):2032–7.  https://doi.org/10.1007/s00167-014-3293-x.CrossRefPubMedGoogle Scholar
  13. 13.
    Suarez-Ahedo C, Pavan Vemula S, Stake CE, Finley ZA, Martin TJ, Gui C, Domb BG. What are the current indications for use of radiofrequency devices in hip arthroscopy? A systematic review. J Hip Preserv Surg. 2015;2(4):323–31.  https://doi.org/10.1093/jhps/hnv055.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Kaplan LD, Ernsthausen JM, Bradley JP, Fu FH, Farkas DL. The thermal field of radiofrequency probes at chondroplasty settings. Arthroscopy. 2003;19(6):632–40.CrossRefGoogle Scholar
  15. 15.
    Lu Y, Edwards RB, Cole BJ, Markel MD. Thermal chondroplasty with radiofrequency energy. An in vitro comparison of bipolar and monopolar radiofrequency devices. Am J Sports Med. 2001;29(1):42–9.CrossRefGoogle Scholar
  16. 16.
    Narayanan G, Froud T, Lo K, Barbery KJ, Perez-Rojas E, Yrizarry J. Pain analysis in patients with hepatocellular carcinoma: irreversible electroporation versus radiofrequency ablation-initial observations. Cardiovasc Intervent Radiol. 2013;36(1):176–82.  https://doi.org/10.1007/s00270-012-0426-9.CrossRefPubMedGoogle Scholar
  17. 17.
    Crawford K, Philippon MJ, Sekiya JK, Rodkey WG, Steadman JR. Microfracture of the hip in athletes. Clin Sports Med. 2006;25(2):327–35.  https://doi.org/10.1016/j.csm.2005.12.004.CrossRefPubMedGoogle Scholar
  18. 18.
    Yen YM, Kocher MS. Chondral lesions of the hip: microfracture and chondroplasty. Sports Med Arthrosc Rev. 2010;18(2):83–9.  https://doi.org/10.1097/JSA.0b013e3181de1189.CrossRefPubMedGoogle Scholar
  19. 19.
    Trask DJ, Keene JS. Analysis of the current indications for microfracture of chondral lesions in the hip joint. Am J Sports Med. 2016;44(12):3070–6.  https://doi.org/10.1177/0363546516655141.CrossRefPubMedGoogle Scholar
  20. 20.
    Haviv B, Singh PJ, Takla A, O’Donnell J. Arthroscopic femoral osteochondroplasty for cam lesions with isolated acetabular chondral damage. J Bone Joint Surg (Br). 2010;92-B(5):629–33.  https://doi.org/10.1302/0301-620x.92b5.23667.CrossRefGoogle Scholar
  21. 21.
    Karthikeyan S, Roberts S, Griffin D. Microfracture for acetabular chondral defects in patients with femoroacetabular impingement. Am J Sports Med. 2012;40(12):2725–30.  https://doi.org/10.1177/0363546512465400.CrossRefPubMedGoogle Scholar
  22. 22.
    McDonald JE, Herzog MM, Philippon MJ. Performance outcomes in professional hockey players following arthroscopic treatment of FAI and microfracture of the hip. Knee Surg Sports Traumatol Arthrosc. 2014;22(4):915–9.  https://doi.org/10.1007/s00167-013-2691-9.CrossRefPubMedGoogle Scholar
  23. 23.
    Philippon MJ, Schenker ML, Briggs KK, Maxwell RB. Can microfracture produce repair tissue in acetabular chondral defects? Arthroscopy. 2008;24(1):46–50.  https://doi.org/10.1016/j.arthro.2007.07.027.CrossRefPubMedGoogle Scholar
  24. 24.
    Philippon MJ, Briggs KK, Yen Y-M, Kuppersmith DA. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br. 2009;91-B(1):16–23.  https://doi.org/10.1302/0301-620x.91b1.21329.CrossRefGoogle Scholar
  25. 25.
    Karthikeyan S, Roberts S, Griffin D. Microfracture for acetabular chondral defects in patients with femoroacetabular impingement: results at second-look arthroscopic surgery. Am J Sports Med. 2012;40(12):2725–30.  https://doi.org/10.1177/0363546512465400.CrossRefPubMedGoogle Scholar
  26. 26.
    Singh PJ, O’Donnell JM. The outcome of hip arthroscopy in Australian football league players: a review of 27 hips. Arthroscopy. 2010;26(6):743–9.  https://doi.org/10.1016/j.arthro.2009.10.010.CrossRefPubMedGoogle Scholar
  27. 27.
    Philippon M, Schenker M, Briggs K, Kuppersmith D. Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):908–14.  https://doi.org/10.1007/s00167-007-0332-x.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Schallmo MS, Marquez-Lara A, Luo TD, Rosas S, Stubbs AJ. Arthroscopic treatment of hip chondral defect with microfracture and platelet-rich plasma-infused micronized cartilage allograft augmentation. Arthrosc Tech. 2018;7(4):e361–e5.  https://doi.org/10.1016/j.eats.2017.10.005.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Fickert S, Schattenberg T, Niks M, Weiss C, Thier S. Feasibility of arthroscopic 3-dimensional, purely autologous chondrocyte transplantation for chondral defects of the hip: a case series. Arch Orthop Trauma Surg. 2014;134(7):971–8.  https://doi.org/10.1007/s00402-014-1997-5.CrossRefPubMedGoogle Scholar
  30. 30.
    Fontana A, Bistolfi A, Crova M, Rosso F, Massazza G. Arthroscopic treatment of hip chondral defects: autologous chondrocyte transplantation versus simple debridement--a pilot study. Arthroscopy. 2012;28(3):322–9.  https://doi.org/10.1016/j.arthro.2011.08.304.CrossRefPubMedGoogle Scholar
  31. 31.
    Stafford GH, Bunn JR, Villar RN. Arthroscopic repair of delaminated acetabular articular cartilage using fibrin adhesive. Results at one to three years. Hip Int. 2011;21(6):744–50.  https://doi.org/10.5301/HIP.2011.8843.CrossRefPubMedGoogle Scholar
  32. 32.
    Tzaveas AP, Villar RN. Arthroscopic repair of acetabular chondral delamination with fibrin adhesive. Hip Int. 2010;20(1):115–9.CrossRefGoogle Scholar
  33. 33.
    Cetinkaya S, Toker B, Taser O. Arthroscopic retrograde osteochondral autologous transplantation to chondral lesion in femoral head. Orthopedics. 2014;37(6):e600–4.  https://doi.org/10.3928/01477447-20140528-64.CrossRefPubMedGoogle Scholar
  34. 34.
    Narvani AA, Tsiridis E, Kendall S, Chaudhuri R, Thomas P. A preliminary report on prevalence of acetabular labrum tears in sports patients with groin pain. Knee Surg Sports Traumatol Arthrosc. 2003;11(6):403–8.  https://doi.org/10.1007/s00167-003-0390-7.CrossRefPubMedGoogle Scholar
  35. 35.
    Silvis ML, Mosher TJ, Smetana BS, Chinchilli VM, Flemming DJ, Walker EA, Black KP. High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players. Am J Sports Med. 2011;39(4):715–21.  https://doi.org/10.1177/0363546510388931.CrossRefPubMedGoogle Scholar
  36. 36.
    Tan V, Seldes RM, Katz MA, Freedhand AM, Klimkiewicz JJ, Fitzgerald RH Jr. Contribution of acetabular labrum to articulating surface area and femoral head coverage in adult hip joints: an anatomic study in cadavera. Am J Orthop. 2001;30(11):809–12.PubMedGoogle Scholar
  37. 37.
    Ferguson SJ, Bryant JT, Ganz R, Ito K. The influence of the acetabular labrum on hip joint cartilage consolidation: a poroelastic finite element model. J Biomech. 2000;33(8):953–60.CrossRefGoogle Scholar
  38. 38.
    Burnett RS, Della Rocca GJ, Prather H, Curry M, Maloney WJ, Clohisy JC. Clinical presentation of patients with tears of the acetabular labrum. J Bone Joint Surg Am. 2006;88(7):1448–57.  https://doi.org/10.2106/JBJS.D.02806.CrossRefPubMedGoogle Scholar
  39. 39.
    Hofmann S, Tschauner C, Urban M, Eder T, Czerny C. Clinical and imaging diagnosis of lesions of the labrum acetabulare. Orthopade. 1998;27(10):681–9.  https://doi.org/10.1007/PL00003453.CrossRefPubMedGoogle Scholar
  40. 40.
    Clohisy JC, Knaus ER, Hunt DM, Lesher JM, Harris-Hayes M, Prather H. Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res. 2009;467(3):638–44.  https://doi.org/10.1007/s11999-008-0680-y.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Clohisy JC, Carlisle JC, Beaule PE, Kim YJ, Trousdale RT, Sierra RJ, Leunig M, Schoenecker PL, Millis MB. A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008;90(Suppl 4):47–66.  https://doi.org/10.2106/JBJS.H.00756.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Linda DD, Naraghi A, Murnaghan L, Whelan D, White LM. Accuracy of non-arthrographic 3T MR imaging in evaluation of intra-articular pathology of the hip in femoroacetabular impingement. Skelet Radiol. 2017;46(3):299–308.  https://doi.org/10.1007/s00256-016-2551-z.CrossRefGoogle Scholar
  43. 43.
    Crespo-Rodriguez AM, De Lucas-Villarrubia JC, Pastrana-Ledesma M, Hualde-Juvera A, Mendez-Alonso S, Padron M. The diagnostic performance of non-contrast 3-Tesla magnetic resonance imaging (3-T MRI) versus 1.5-Tesla magnetic resonance arthrography (1.5-T MRA) in femoro-acetabular impingement. Eur J Radiol. 2017;88:109–16.  https://doi.org/10.1016/j.ejrad.2016.12.031.CrossRefPubMedGoogle Scholar
  44. 44.
    Geeslin AG, Geeslin MG, Chahla J, Mannava S, Frangiamore S, Philippon MJ. Comprehensive clinical evaluation of femoroacetabular impingement: part 3, magnetic resonance imaging. Arthrosc Tech. 2017;6(5):e2011–e8.  https://doi.org/10.1016/j.eats.2017.06.062.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Philippon MJ, Weiss DR, Kuppersmith DA, Briggs KK, Hay CJ. Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players. Am J Sports Med. 2010;38(1):99–104.  https://doi.org/10.1177/0363546509346393.CrossRefPubMedGoogle Scholar
  46. 46.
    Larson CM, Giveans MR, Stone RM. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement: mean 3.5-year follow-up. Am J Sports Med. 2012;40(5):1015–21.  https://doi.org/10.1177/0363546511434578.CrossRefPubMedGoogle Scholar
  47. 47.
    Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am. 2006;88(5):925–35.  https://doi.org/10.2106/JBJS.E.00290.CrossRefPubMedGoogle Scholar
  48. 48.
    Kollmorgen R, Mather R. Current concepts in labral repair and refixation: anatomical approach to labral management. Am J Orthop. 2017;46(1):42–8.PubMedGoogle Scholar
  49. 49.
    Shindle MK, Voos JE, Nho SJ, Heyworth BE, Kelly BT. Arthroscopic management of labral tears in the hip. J Bone Joint Surg Am. 2008;90(Suppl 4):2–19.  https://doi.org/10.2106/JBJS.H.00686.CrossRefPubMedGoogle Scholar
  50. 50.
    Greaves LL, Gilbart MK, Yung A, Kozlowski P, Wilson DR. Deformation and recovery of cartilage in the intact hip under physiological loads using 7T MRI. J Biomech. 2009;42(3):349–54.  https://doi.org/10.1016/j.jbiomech.2008.11.025.CrossRefPubMedGoogle Scholar
  51. 51.
    Kelly BT, Shapiro GS, Digiovanni CW, Buly RL, Potter HG, Hannafin JA. Vascularity of the hip labrum: a cadaveric investigation. Arthroscopy. 2005;21(1):3–11.  https://doi.org/10.1016/j.arthro.2004.09.016.CrossRefPubMedGoogle Scholar
  52. 52.
    Turker M, Kilicoglu O, Goksan B, Bilgic B. Vascularity and histology of fetal labrum and chondrolabral junction: its relevance to chondrolabral detachment tears. Knee Surg Sports Traumatol Arthrosc. 2012;20(2):381–6.  https://doi.org/10.1007/s00167-011-1566-1.CrossRefPubMedGoogle Scholar
  53. 53.
    Philippon MJ, Schenker ML. A new method for acetabular rim trimming and labral repair. Clin Sports Med. 2006;25(2):293–7., ix.  https://doi.org/10.1016/j.csm.2005.12.005.CrossRefPubMedGoogle Scholar
  54. 54.
    Domb BG, Hartigan DE, Perets I. Decision making for labral treatment in the hip: repair versus debridement versus reconstruction. J Am Acad Orthop Surg. 2017;25(3):e53–62.  https://doi.org/10.5435/JAAOS-D-16-00144.CrossRefPubMedGoogle Scholar
  55. 55.
    Boykin RE, Patterson D, Briggs KK, Dee A, Philippon MJ. Results of arthroscopic labral reconstruction of the hip in elite athletes. Am J Sports Med. 2013;41(10):2296–301.  https://doi.org/10.1177/0363546513498058.CrossRefPubMedGoogle Scholar
  56. 56.
    Philippon MJ, Faucet SC, Briggs KK. Arthroscopic hip labral repair. Arthrosc Tech. 2013;2(2):e73–6.  https://doi.org/10.1016/j.eats.2012.11.002.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Rhee SM, Kang SY, Jang EC, Kim JY, Ha YC. Clinical outcomes after arthroscopic acetabular labral repair using knot-tying or knotless suture technique. Arch Orthop Trauma Surg. 2016;136(10):1411–6.  https://doi.org/10.1007/s00402-016-2505-x.CrossRefPubMedGoogle Scholar
  58. 58.
    Sawyer GA, Briggs KK, Dornan GJ, Ommen ND, Philippon MJ. Clinical outcomes after arthroscopic hip labral repair using looped versus pierced suture techniques. Am J Sports Med. 2015;43(7):1683–8.  https://doi.org/10.1177/0363546515581469.CrossRefPubMedGoogle Scholar
  59. 59.
    Kelly BT, Weiland DE, Schenker ML, Philippon MJ. Arthroscopic labral repair in the hip: surgical technique and review of the literature. Arthroscopy. 2005;21(12):1496–504.  https://doi.org/10.1016/j.arthro.2005.08.013.CrossRefPubMedGoogle Scholar
  60. 60.
    Jackson TJ, Hammarstedt JE, Vemula SP, Domb BG. Acetabular labral base repair versus circumferential suture repair: a matched-paired comparison of clinical outcomes. Arthroscopy. 2015;31(9):1716–21.  https://doi.org/10.1016/j.arthro.2015.03.004.CrossRefGoogle Scholar
  61. 61.
    Lertwanich P, Ejnisman L, Torry MR, Giphart JE, Philippon MJ. Defining a safety margin for labral suture anchor insertion using the acetabular rim angle. Am J Sports Med. 2011;39(Suppl):111S–6S.  https://doi.org/10.1177/0363546511413746.CrossRefPubMedGoogle Scholar
  62. 62.
    LaFrance R, Kenney R, Giordano B, Mohr K, Cabrera J, Snibbe J. The effect of platelet enriched plasma on clinical outcomes in patients with femoroacetabular impingement following arthroscopic labral repair and femoral neck osteoplasty. J Hip Preserv Surg. 2015;2(2):158–63.  https://doi.org/10.1093/jhps/hnv023.CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Menge TJ, Briggs KK, Dornan GJ, McNamara SC, Philippon MJ. Survivorship and outcomes 10 years following hip arthroscopy for femoroacetabular impingement: labral debridement compared with labral repair. J Bone Joint Surg Am. 2017;99(12):997–1004.  https://doi.org/10.2106/JBJS.16.01060.CrossRefPubMedGoogle Scholar
  64. 64.
    Domb BG, Yuen LC, Ortiz-Declet V, Litrenta J, Perets I, Chen AW. Arthroscopic labral base repair in the hip: 5-year minimum clinical outcomes. Am J Sports Med. 2017;45(12):2882–90.  https://doi.org/10.1177/0363546517713731.CrossRefPubMedGoogle Scholar
  65. 65.
    Mohan R, Johnson NR, Hevesi M, Gibbs CM, Levy BA, Krych AJ. Return to sport and clinical outcomes after hip arthroscopic labral repair in young amateur athletes: minimum 2-year follow-up. Arthroscopy. 2017;33(9):1679–84.  https://doi.org/10.1016/j.arthro.2017.03.011.CrossRefPubMedGoogle Scholar
  66. 66.
    Scanaliato JP, Christensen DL, Salfiti C, Herzog MM, Wolff AB. Primary circumferential acetabular labral reconstruction: achieving outcomes similar to primary labral repair despite more challenging patient characteristics. Am J Sports Med. 2018;46(9):2079–88.  https://doi.org/10.1177/0363546518775425.CrossRefPubMedGoogle Scholar
  67. 67.
    White BJ, Patterson J, Herzog MM. Bilateral hip arthroscopy: direct comparison of primary acetabular labral repair and primary acetabular labral reconstruction. Arthroscopy. 2018;34(2):433–40.  https://doi.org/10.1016/j.arthro.2017.08.240.CrossRefPubMedGoogle Scholar
  68. 68.
    Philippon MJ, Nepple JJ, Campbell KJ, Dornan GJ, Jansson KS, LaPrade RF, Wijdicks CA. 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.  https://doi.org/10.1007/s00167-014-2874-z.CrossRefPubMedGoogle Scholar
  69. 69.
    White BJ, Stapleford AB, Hawkes TK, Finger MJ, Herzog MM. Allograft use in arthroscopic labral reconstruction of the hip with front-to-back fixation technique: minimum 2-year follow-up. Arthroscopy. 2016;32(1):26–32.  https://doi.org/10.1016/j.arthro.2015.07.016.CrossRefPubMedGoogle Scholar
  70. 70.
    Youm T. Editorial commentary: Wanted dead or alive: primary allograft labral reconstruction of the hip is as successful, if not more successful, than primary labral repair. Arthroscopy. 2018;34(2):441–3.  https://doi.org/10.1016/j.arthro.2017.09.011.CrossRefPubMedGoogle Scholar
  71. 71.
    Forster-Horvath C, von Rotz N, Giordano BD, Domb BG. Acetabular labral debridement/segmental resection versus reconstruction in the comprehensive treatment of symptomatic femoroacetabular impingement: a systematic review. Arthroscopy. 2016;32(11):2401–15.  https://doi.org/10.1016/j.arthro.2016.04.035.CrossRefPubMedGoogle Scholar
  72. 72.
    White BJ, Herzog MM. Labral reconstruction: when to perform and how. Front Surg. 2015;2:27.  https://doi.org/10.3389/fsurg.2015.00027.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Cvetanovich GL, Weber AE, Kuhns BD, Alter J, Harris JD, Mather RC, Nho SJ. Hip arthroscopic surgery for femoroacetabular impingement with capsular management: factors associated with achieving clinically significant outcomes. Am J Sports Med. 2018;46(2):288–96.  https://doi.org/10.1177/0363546517739824.CrossRefPubMedGoogle Scholar
  74. 74.
    Philippon MJ, Briggs KK, Hay CJ, Kuppersmith DA, Dewing CB, Huang MJ. Arthroscopic labral reconstruction in the hip using iliotibial band autograft: technique and early outcomes. Arthroscopy. 2010;26(6):750–6.  https://doi.org/10.1016/j.arthro.2009.10.016.CrossRefPubMedGoogle Scholar
  75. 75.
    Geyer MR, Philippon MJ, Fagrelius TS, Briggs KK. Acetabular labral reconstruction with an iliotibial band autograft: outcome and survivorship analysis at minimum 3-year follow-up. Am J Sports Med. 2013;41(8):1750–6.  https://doi.org/10.1177/0363546513487311.CrossRefPubMedGoogle Scholar
  76. 76.
    Redmond JM, Cregar WM, Martin TJ, Vemula SP, Gupta A, Domb BG. Arthroscopic labral reconstruction of the hip using semitendinosus allograft. Arthrosc Tech. 2015;4(4):e323–9.  https://doi.org/10.1016/j.eats.2015.03.002.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Park SE, Ko Y. Use of the quadriceps tendon in arthroscopic acetabular labral reconstruction: potential and benefits as an autograft option. Arthrosc Tech. 2013;2(3):e217–9.  https://doi.org/10.1016/j.eats.2013.02.003.CrossRefPubMedPubMedCentralGoogle Scholar
  78. 78.
    Matsuda DK. Arthroscopic labral reconstruction with gracilis autograft. Arthrosc Tech. 2012;1(1):e15–21.  https://doi.org/10.1016/j.eats.2011.12.001.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Locks R, Chahla J, Bolia IK, Briggs KK, Philippon MJ. Outcomes following arthroscopic hip segmental labral reconstruction using autologous capsule tissue or indirect head of the rectus tendon. J Hip Preserv Surg. 2018;5(1):73–7.  https://doi.org/10.1093/jhps/hnx033.CrossRefPubMedGoogle Scholar
  80. 80.
    Rathi R, Mazek J. Arthroscopic acetabular labral reconstruction with fascia lata allograft: clinical outcomes at minimum one-year follow-up. Open Orthop J. 2017;11:554–61.  https://doi.org/10.2174/1874325001611010554.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Gomez EM, Cardenas C, Astarita E, Bellotti V, Tresserra F, Natera LG, Ribas M. Labral reconstruction with tendon allograft: histological findings show revascularization at 8 weeks from implantation. J Hip Preserv Surg. 2017;4(1):74–9.  https://doi.org/10.1093/jhps/hnx001.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    MacInnis LE, Al Hussain A, Coady C, Wong IH. Labral gracilis tendon allograft reconstruction and cartilage regeneration scaffold for an uncontained acetabular cartilage defect of the hip. Arthrosc Tech. 2017;6(3):e613–e9.  https://doi.org/10.1016/j.eats.2017.01.005.CrossRefPubMedPubMedCentralGoogle Scholar
  83. 83.
    Domb BG, El Bitar YF, Stake CE, Trenga AP, Jackson TJ, Lindner D. Arthroscopic labral reconstruction is superior to segmental resection for irreparable labral tears in the hip: a matched-pair controlled study with minimum 2-year follow-up. Am J Sports Med. 2014;42(1):122–30.  https://doi.org/10.1177/0363546513508256.CrossRefPubMedGoogle Scholar
  84. 84.
    Ejnisman L, Philippon MJ, Lertwanich P. Acetabular labral tears: diagnosis, repair, and a method for labral reconstruction. Clin Sports Med. 2011;30(2):317–29.  https://doi.org/10.1016/j.csm.2010.12.006.CrossRefPubMedGoogle Scholar
  85. 85.
    Cvetanovich GL, Lizzio V, Meta F, Chan D, Zaltz I, Nho SJ, Makhni EC. Variability and comprehensiveness of North American online available physical therapy protocols following hip arthroscopy for femoroacetabular impingement and labral repair. Arthroscopy. 2017;33(11):1998–2005.  https://doi.org/10.1016/j.arthro.2017.06.045.CrossRefPubMedGoogle Scholar
  86. 86.
    Wahoff M, Dischiavi S, Hodge J, Pharez JD. Rehabilitation after labral repair and femoroacetabular decompression: criteria-based progression through the return to sport phase. Int J Sports Phys Ther. 2014;9(6):813–26.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Philippon MJ, Christensen JC, Wahoff MS. Rehabilitation after arthroscopic repair of intra-articular disorders of the hip in a professional football athlete. J Sport Rehabil. 2009;18(1):118–34.CrossRefGoogle Scholar
  88. 88.
    Stalzer S, Wahoff M, Scanlan M. Rehabilitation following hip arthroscopy. Clin Sports Med. 2006;25(2):337–57.  https://doi.org/10.1016/j.csm.2005.12.008.CrossRefPubMedGoogle Scholar
  89. 89.
    Cheatham SW, Kolber MJ. Rehabilitation after hip arthroscopy and labral repair in a high school football athlete: a 3.6 year follow-up with insight into potential risk factors. Int J Sports Phys Ther. 2015;10(4):530–9.PubMedPubMedCentralGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  • Alejandro Marquez-Lara
    • 1
  • T. David Luo
    • 1
  • Allston J. Stubbs
    • 1
    Email author
  1. 1.Wake Forest University School of MedicineWinston-SalemUSA

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