1
|
Mazek J, Helmy N, Salas AP, Skowronek P, Madej A, O´Donnell JM, Dimitriou D. Quantitative cotyloid fossa thickness and proximity to obturator neurovascular bundle: implications for arthroscopic ligamentum teres reconstruction. J Hip Preserv Surg 2023; 10:192-196. [PMID: 38162273 PMCID: PMC10757420 DOI: 10.1093/jhps/hnad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/15/2023] [Accepted: 06/17/2023] [Indexed: 01/03/2024] Open
Abstract
The aim of the present study was to report the in vivo thickness of the cotyloid fossa at the acetabular ligamentum teres (LT) attachment and investigate the clearance of the obturator neurovascular bundle. Fifty-five consecutive patients undergoing a total hip arthroplasty for hip osteoarthritis were included. The thickness of the cotyloid fossa was measured at the acetabular LT attachment using a standard depth gauge. The minimal distance (clearance) of the obturator neurovascular bundle to the center of the acetabular LT attachment was measured in 7 patients (14 hips) who also underwent a computed tomography angiography. The average thickness of the cotyloid fossa at the acetabular LT attachment was 4.1 ± 2.3 (range: 1-10) mm. The obturator vein was closest to the acetabular LT attachment, but the clearance was more than the defined safe zone of 15 mm in all cases. Based on the current findings, it can be assumed that bone anchors might not be suitable for fixation of the graft in LT reconstruction (LTR) and an alternative implant such as a cortical button should be considered. Acetabular fixation of the graft with a 12-mm cortical button is relatively safe concerning injury to obturator neurovascular structures. The results of the present study provide a better understanding of the cotyloid fossa anatomy and might be relevant for surgeons who perform arthroscopic LTR.
Collapse
Affiliation(s)
- Jacek Mazek
- Clinic of Orthopaedic and Traumatology, Regional Hospital and Kochanowski Medical University, Grunwaldzka 45, Kielce 25-736, Poland
| | - Nader Helmy
- Department of Orthopaedics and Traumatology, Bürgerspital Solothurn, Schöngrünstrasse 42, Solothurn 4500, Switzerland
| | - Antonio Porthos Salas
- Hip Arthroscopy of Mexico, Hospital Angeles Valle Oriente, Av. Cto. Frida Kahlo 180, Valle Oriente, San Pedro Garza García, N.L. 66260, Mexico
| | - Pawel Skowronek
- Clinic of Orthopaedic and Traumatology, Regional Hospital and Kochanowski Medical University, Grunwaldzka 45, Kielce 25-736, Poland
| | - Arkadiusz Madej
- Clinic of Orthopaedic and Traumatology, Regional Hospital and Kochanowski Medical University, Grunwaldzka 45, Kielce 25-736, Poland
| | - John M O´Donnell
- Hip Arthroscopy Australia, 21 Erin St, Richmond, Melbourne, VIC, Australia
| | - Dimitris Dimitriou
- Department of Orthopedics, University Hospital Balgrist, University of Zurich, Forchstrasse 340, Zürich 8008, Switzerland
| |
Collapse
|
2
|
Salas AP, Mazek J, María AC, Taffinder DS, Velasco-Vazquez H. Hip Arthroscopy in Adolescents Through an Extra-Capsular Approach. Arthrosc Tech 2023; 12:e867-e871. [PMID: 37424655 PMCID: PMC10323734 DOI: 10.1016/j.eats.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/12/2023] [Accepted: 02/11/2023] [Indexed: 07/11/2023] Open
Abstract
Hip arthroscopic treatment for femoroacetabular impingement syndrome and labral tears is the gold standard in the adult and adolescent population, as we all know the most common surgical approach to the hip is entering the central compartment with fluoroscopy and with continuous distraction. A periportal capsulotomy in traction must be done to have visibility and instrument maneuverability. These maneuvers avoid scuffing the femoral head cartilage. In adolescents, extreme care must be taken in hip distraction, as the force used can cause iatrogenic neurovascular lesions, avascular necrosis, and lacerations of the genitals and foot/ankle. Experienced surgeons around the world have developed an extracapsular approach to the hip with smaller capsulotomies with a low complication rate. This approach to the hip has brought attention in the adolescent population because it is more secure and simple. Less force of distraction is needed because the capsulotomy is done first. This surgical technique allows observation of the cam morphology while entering to the hip without distraction. We describe an extracapsular approach as an option to treat femoral acetabular impingement syndrome and labral tears in the pediatric and adolescent population.
Collapse
Affiliation(s)
- Antonio Porthos Salas
- Address correspondence to Antonio Porthos Salas, M.D., Hip Arthroscopy Mexico, San Pedro Garza Garcia, Nuevo Leon, 66275, Mexico.
| | | | | | | | | |
Collapse
|
3
|
Salas AP, Mazek J, O'Donnell J, Mendez-Perez E, Brizuela-Ventura M, Velasco-Vazquez HA, Meza F. Hip Arthroscopy and Core Decompression for Avascular Necrosis of the Femoral Head Using a Specific Aiming Guide: A Step-by-Step Surgical Technique. Arthrosc Tech 2021; 10:e2775-e2782. [PMID: 35004160 PMCID: PMC8719135 DOI: 10.1016/j.eats.2021.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/13/2021] [Indexed: 02/03/2023] Open
Abstract
Avascular necrosis of the femoral (AVN) head is a disabling disease that affects function, mobility, and quality of life in the young adult. Its pathology involves blood circulation disruption of the femoral head and subchondral infarction. This leads to cartilage thinning, femoral head depression, and cartilage breakage, which results in hip osteoarthritis. In the past decade the prevalence of intraarticular pathology has been almost 95%, this revealed with hip arthroscopy (HA). HA and core decompression (CD) of the femoral head can be used effectively and concomitantly to treat AVN with excellent results, HA allows for excellent visualization of the hip joint cartilage, allowing treatment of femoroacetabular impingement syndrome (FAIS) and intra-articular pathology. Our technique demonstrates that retrograde core decompression with allograft and mixed bone matrix is an excellent choice of treatment in the early stages of AVN/ONFH. The femoral head-specific aiming guide is very reliable, is simple to use arthroscopically if placed in the posterolateral portal of the hip, and offers exact pin placement at the necrotic site, as well as less operative time and less radiation to the patient and surgical team.
Collapse
Affiliation(s)
- Antonio Porthos Salas
- Hip Arthroscopy Mexico, San Pedro Garza García, México,Address correspondence to Antonio Porthos Salas, Hip Arthroscopy Mexico, Montes Rocallosos 209, San Pedro Garza García, México, 66290.
| | - Jacek Mazek
- Ortopedika Hospital Hip Unit, Warsaw, Poland,Collegium Medicum Jan Kochanowski University, Orthopaedic and Trauma Clinic Hospital, Kielce, Poland
| | | | | | | | | | | |
Collapse
|
4
|
Mazek J, Gnatowski M, Salas AP, O'Donnell JM, Domżalski M, Radzimowski J. Arthroscopic utilization of ChondroFiller gel for the treatment of hip articular cartilage defects: a cohort study with 12- to 60-month follow-up. J Hip Preserv Surg 2021; 8:22-27. [PMID: 34567597 PMCID: PMC8460160 DOI: 10.1093/jhps/hnab002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 10/19/2020] [Indexed: 12/25/2022] Open
Abstract
ChondroFiller gel is an absorbable collagen implant. It serves as a protective cover for the cartilage defects, allowing chondrocyte migration into the lesion. The implant consists of collagen (Type I) and is derived from veterinary monitored rats. This study evaluates the use of ChondroFiller gel in the treatment of cartilage lesions during hip joint arthroscopy. A prospective study was conducted on a group of 26 adult patients. All patients had an existing femoroacetabular impingement together with acetabular cartilage lesions >2 cm2. All patients underwent hip arthroscopic surgery and the lesions were treated using ChondroFiller gel. The cartilage tissue healing was evaluated postoperatively using MRI. A total of 26 patients, including 5 females and 21 males, all with articular cartilage lesions, were included in the study. Cartilage healing conditions were evaluated for all patients, and the difference between pre- and post-surgery conditions was statistically significant. The follow-up scores have been acquired from 21 out of initial 26 patients (2 were disqualified after receiving THR, 3 could not be reached by researchers) after 3, 4 and 5 years consecutively with 17/21 patients having good/excellent results. The use of ChondroFiller gel during arthroscopy of the hip for acetabular cartilage lesions is an effective treatment technique. Encouraging long-term results have been observed, but further research on larger group of patient is required to better assess the full value of this technique. Patients with pre-existing osteoarthritis (Tönnis 2–3) have poor results.
Collapse
Affiliation(s)
- Jacek Mazek
- Jan Kochanowski University in Kielce, Orthopaedic and Traumatology Clinic, Kielce, Poland
| | - Maciej Gnatowski
- Center for Specialized Surgery Ortopedika, 03-152 Warsaw, Poland
| | | | - John M O'Donnell
- Hip Arthroscopy Australia, 21 Erin Street, Richmond, Victoria 3121, Australia
| | - Marcin Domżalski
- Orthopedic and Trauma Department, Medical University of Lodz, Lodz, Poland
| | - Jakub Radzimowski
- Orthopaedic and Traumatology Clinic WUM, Miedzyleski Hospital Warsaw, Warsaw, Poland
| |
Collapse
|
5
|
Mazek J, Gnatowski M, Salas AP, Domżalski M, Wójcicki R, Skowronek J, Skowronek P. Ligamentum teres reconstruction with labrum and capsule repair after posterior acetabular wall fracture: a case report. J Hip Preserv Surg 2021; 8:i41-i45. [PMID: 34178370 PMCID: PMC8221382 DOI: 10.1093/jhps/hnab029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/16/2021] [Indexed: 01/12/2023] Open
Abstract
The aim of this case study is to present arthroscopic treatment of recurrent hip instability after acute post-traumatic posterior hip dislocation with a fracture of the posterior acetabular wall. A male patient aged 35 suffered a dislocation of the right hip joint with a fracture of the posterior acetabular wall due to an accident. The fracture was stabilized during emergency surgery with a locking compression plate, and the patient was released home in a hip brace. Multiple dislocations of the hip joint followed with the implant being confirmed as stable. Decision was made to qualify the patient for a right hip arthroscopy. During the surgery, ligamentum teres was reconstructed using gracilis and semitendinous muscle grafts, followed by the labrum and joint capsule repair, where the surgery that stabilized the acetabular wall fracture had damaged them. There were no complications following the procedure. Short-term follow-up of 3 months demonstrates the patient has a stable hip, reduced pain and has returned to pre-injury activities.
Collapse
Affiliation(s)
- Jacek Mazek
- Jan Kochanowski University in Kielce, Orthopaedic and Traumatology Clinic, Kielce, Poland.,Center for Specialized Surgery Ortopedika, 03-152 Warsaw, Poland
| | - Maciej Gnatowski
- Center for Specialized Surgery Ortopedika, 03-152 Warsaw, Poland
| | | | - Marcin Domżalski
- Orthopaedic and Trauma Department, Medical University of Lodz, Lodz, Poland
| | - Rafał Wójcicki
- Jan Kochanowski University in Kielce, Orthopaedic and Traumatology Clinic, Kielce, Poland
| | - Jacek Skowronek
- Jan Kochanowski University in Kielce, Orthopaedic and Traumatology Clinic, Kielce, Poland
| | - Paweł Skowronek
- Jan Kochanowski University in Kielce, Orthopaedic and Traumatology Clinic, Kielce, Poland
| |
Collapse
|
6
|
Salas AP, Mendez-Perez E, Mazek J, Velasco-Vazquez H, Castillo-Trevizo A. The Yoga Mat Technique in Postless Hip Arthroscopy. Arthrosc Tech 2021; 10:e1525-e1530. [PMID: 34258200 PMCID: PMC8252824 DOI: 10.1016/j.eats.2021.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/13/2021] [Indexed: 02/03/2023] Open
Abstract
Hip arthroscopy for the treatment of femoroacetabular impingement syndrome with anti-sliding techniques and without the use of a perineal post to achieve hip distraction has increased greatly in the past 5 to 10 years. To access the hip joint, distraction is mandatory to treat intra-articular disorders such as labral tears, acetabular cartilage defects, loose bodies, ligamentum teres tears, and avascular necrosis of the hip. In hip distraction, counter-distraction is needed, and this is achieved with a bulky and cushioned perineal post. Most of the described techniques in hip arthroscopy worldwide use a perineal post, but iatrogenic pudendal nerve, genital lacerations, hematomas, and groin complications have been reported to occur. In Latin American countries, disposable hip pad devices are expensive, and not all the arthroscopic companies provide them. Our yoga mat technique provides enough countertraction to achieve adequate hip distraction. Labral repair, labral reconstruction, and decompression of femoroacetabular impingement syndrome have been achieved properly, reliably, and reproducibly, and no Trendelenburg position is needed. Postless hip arthroscopy is made simple, and positioning the patient is not difficult. Hip surgeons can adapt this technique to a fracture table, a hip distractor, and a standard operating room table.
Collapse
Affiliation(s)
- Antonio Porthos Salas
- Hip Arthroscopy Mexico, San Pedro Garza García, México,Address correspondence to Antonio Porthos Salas, M.D., Hip Arthroscopy Mexico, San Pedro Garza Garcia, Nuevo Leon, Mexico.
| | | | - Jacek Mazek
- Ortopedika Hospital Hip Unit, Warsaw, Poland
| | | | | |
Collapse
|
7
|
Salas AP, Brizuela-Ventura M, Velasco-Vazquez H, Mazek J. The Outside-In Technique for Slipped Capital Femoral Epiphysis: A Safe and Reproducible Approach in Hip Arthroscopy. Arthrosc Tech 2020; 9:e493-e497. [PMID: 32368469 PMCID: PMC7189202 DOI: 10.1016/j.eats.2019.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/03/2019] [Indexed: 02/03/2023] Open
Abstract
Femoroacetabular impingement syndrome caused by slipped capital femoral epiphysis (SCFE) can be successfully treated arthroscopically and with the minimally invasive, outside-in surgical technique. The advantages of the technique are that the residual cam-type deformity caused by the slippage can be corrected and reconstructed reliably and reproducibly before distracting the hip joint; and radiation with fluoroscopy is used for only definitive reduction and reconstruction, which is obtained with cannulated screws. In addition, this safe technique allows distraction of the hip after screw placement, without affecting the reconstruction, to address labral tears and chondrolabral delaminations caused by the impingement.
Collapse
Affiliation(s)
- Antonio Porthos Salas
- Hip Arthroscopy and Preservation Mexico, San Pedro Garza Garcia, Mexico
- Address correspondence to Antonio Porthos Salas, M.D., Hip Arthroscopy and Preservation Mexico, Hospital Angeles Valle Oriente, Montes Rocallosos 209, 66290 San Pedro Garza Garcia, Mexico.
| | | | | | | |
Collapse
|
8
|
Salas AP, Mazek J, Araujo-Reyes D, Gonzalez-Campos M, Castillo-Trevizo A, Garcia JM. The Tutankhamun Technique in Hip Arthroscopy. Arthrosc Tech 2018; 7:e1167-e1171. [PMID: 30533364 PMCID: PMC6262244 DOI: 10.1016/j.eats.2018.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/30/2018] [Indexed: 02/03/2023] Open
Abstract
Hip arthroscopy has been increasing tremendously in the past decade and is a very common surgical procedure to repair femoroacetabular impingement. To access the hip joint, distraction is mandatory to treat intra-articular disorders such as labral tears, cartilage loose bodies, and ligamentum teres tears and to evaluate the condition of the femoral head and acetabular cartilage. To distract the hip, counterdistraction is needed, and this is achieved with placement of a bulky and cushioned perineal post. Most of the described techniques in hip arthroscopy use a perineal post, whereas others use beanbags to place the patient's body on the surgical table. Still others do not use a post at all but rather use gravity and a Trendelenburg position to achieve distraction. Our technique does not use a perineal post but instead uses heavy-duty tape over the patient's upper body, which is placed on a normal operating room table to distract the hip while entering the central compartment.
Collapse
Affiliation(s)
- Antonio Porthos Salas
- Hip Arthroscopy Mexico, García, México,Hip Arthroscopy Australia, Melbourne, Australia,Address correspondence to Antonio Porthos Salas, M.D., Hip Arthroscopy Mexico, Montes Rocallosos 209, 66290 San Pedro Garza Garcia, Nuevo Leon, Mexico
| | - Jacek Mazek
- Ortopedika Hospital and Enelmed, Warsaw, Poland
| | | | | | | | | |
Collapse
|
9
|
Skowronek P, Olszewski P, Święszkowski W, Synder M, Sibiński M, Mazek J. Unrecoverable bi-products of drilling titanium alloy and tantalum metal implants: a pilot study. Hip Int 2018; 28:531-534. [PMID: 29756501 DOI: 10.1177/1120700018760306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Trabecular metal implants with a porous architecture that allows for the incorporation of bone into the implant during healing are gaining popularity in alloplastic revision procedures. The bi-products of drilling titanium alloy (Ti) and tantalum (Ta) implants have not been previously assessed. METHODS Four holes were drilled in each of 2 spatially porous trabecular implants, one Ta and the other Ti alloy (Ti-6Al-7Nb), for this pilot in vitro study. The particles were flushed out with a continuous flow of saline. The particles' weight and the volume were then measured using a Radwag XA 110/2X (USA) laboratory balance. The total volume of the obtained metal fines was measured by titration using a 10 mm3 measurement system. RESULTS A cobalt carbide bit was used since the holes could not be made with a standard bone drill. Each Ti and Ta implant lost 1.26 g and 2.48 g of mass, respectively. The volume of free particles recovered after each stage was 280 mm3 and 149 mm3, respectively. Approximately 0.6% of the total implant mass was not recovered after drilling (roughly 2% of the mass of the particles created by drilling), despite the use of 5 µm filters. CONCLUSIONS It is technically difficult to drill holes in Ti and Ta implants using standard surgical tools. The drilling process creates a considerable amount of metal particles, which cannot be recovered despite intensive flushing. This may have an adverse influence on the bio-functionality (survival) of the endoprosthesis and present deleterious systemic consequences.
Collapse
Affiliation(s)
- Paweł Skowronek
- 1 Clinic of Orthopaedic and Traumatology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Paweł Olszewski
- 1 Clinic of Orthopaedic and Traumatology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Wojciech Święszkowski
- 2 Department of Materials Engineering at the Warsaw University of Technology, Warsaw, Poland
| | - Marek Synder
- 3 Clinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Lodz, Poland
| | - Marcin Sibiński
- 3 Clinic of Orthopaedics and Paediatric Orthopaedics Medical University of Lodz, Lodz, Poland
| | - Jacek Mazek
- 4 Centre for Specialised Surgery ORTOPEDIKA Warsaw, Warsaw, Poland
| |
Collapse
|
10
|
Rathi R, Mazek J. Arthroscopic acetabular labral reconstruction with rectus femoris tendon autograft: Our experiences and early results. J Orthop 2018; 15:783-786. [PMID: 29997421 DOI: 10.1016/j.jor.2018.05.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/07/2018] [Indexed: 10/28/2022] Open
Abstract
Background The native labrum has been shown to play a critical role in the maintenance of overall health of the cartilage of the hip. Disruption of the labral seal could be detrimental to the overall nutrition of the cartilage, leading to its premature degeneration. Purpose This study sought to investigate patients undergoing labral reconstruction with indirect head of rectus femoris autograft, to determine the subjective improvement in pain they experienced, the complications and reoperation rates including conversion to Total hip replacement(THR). Method We retrospectively reviewed all 7 patients who underwent labral reconstruction using indirect head of the rectus femoris tendon autograft between January 2013 to October 2015. We assessed improvement in pain and function, complications, and subsequent surgery. The minimum follow-up was 12 months (average, 15 months; range, 12-18 months). Results All patients reported subjective improvement in preoperative pain and function. The mean modified Harris Hip Score (mHHS) improved significantly from 56 (54-60) preoperatively to 93 (90-97)) at mean latest follow-up. The mean change of mHHS was 36 (30-43) and mean postoperative patient satisfaction score was 9.1. We observed no radiological progression of arthritis as well as no patient had revision procedure including total hip replacement. Conclusion Acetabular labrum reconstruction for irreparable labral tears in young patients with no significant arthritis, using indirect head of the rectus femoris tendon autograft is a new technique that shows improvement in pain and function post-operatively. Long-term follow-up results with higher quality studies will be necessary to further define the role of labral reconstruction in hip preservation surgery.
Collapse
Affiliation(s)
- Ritesh Rathi
- Hinchinbrook Hospital NHS Trust, Huntingdon, Cambridge, England, United Kingdom
| | - Jacek Mazek
- Centrum Hospital Enel med and Centre for Specialized Surgery ORTOPEDIKA, Warsaw, Poland
| |
Collapse
|
11
|
Rathi R, Mazek J. Arthroscopic Acetabular Labral Reconstruction with Fascia Lata Allograft: Clinical Outcomes at Minimum One-Year Follow-Up. Open Orthop J 2017; 11:554-561. [PMID: 28839500 PMCID: PMC5543695 DOI: 10.2174/1874325001611010554] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 05/07/2017] [Accepted: 05/14/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The integrity of the acetabular labrum is crucial to normal biomechanics of the hip joint. Disruption of the labral seal could be detrimental to the overall nutrition of the cartilage, leading to its premature degeneration. PURPOSE The aim of this study is to determine the clinical effectiveness of arthroscopic hip labral reconstruction using fascia lata allograft. The hypothesis is that labral reconstruction would provide good clinical outcomes. METHODS We retrospectively reviewed all 10 patients who underwent labral reconstruction with fascia lata allograft from January 2013 to October 2015. We assessed improvement in pain and function, complications, and subsequent surgery. The minimum follow-up was 12 months (average, 22.9 months; range, 16-36 months). RESULTS All patients reported subjective improvement in preoperative pain and function. The mean modified Harris hip score improved significantly from 58 (55-60) to 95 (91-98). The mean change of modified Harris hip score was 36 (31-41) and mean post-operative patient satisfaction score was 9.5(8-10). We observed no radiological progression of arthritis as well as no patient had revision procedure including total hip replacement. CONCLUSION Arthroscopic labral reconstruction using a fascia lata tendon allograft is an effective and safe procedure that not only provides excellent clinical outcomes in short term but also potentially prevent continued cartilage degeneration by restoring acetabular labral seal in patients with deficient or resected labrums.
Collapse
Affiliation(s)
- Ritesh Rathi
- Consultant in Trauma and Orthopedics, Hinchinbrook Hospital NHS Trust, Huntingdon, Cambridge, England
| | - Jacek Mazek
- Consultant in Trauma and Orthopedics, Centrum Hospital Enel-med and Centre for Specialized Surgery ORTOPEDIKA, Warsaw, Poland
| |
Collapse
|
12
|
Mioduszewski A, Wrobel M, Sroczynski J, Swierczynski R, Mazek J. Repair of anterior cruciate ligament with internal brace technique – Early results. Asia Pac J Sports Med Arthrosc Rehabil Technol 2016. [DOI: 10.1016/j.asmart.2016.07.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
13
|
Mazek J, Lukawski S, Langner M. [Arthroscopy scapulothoracic articulation (introduction of this method)]. Chir Narzadow Ruchu Ortop Pol 2006; 71:141-2. [PMID: 17133839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The authors have introduced arthroscopy of scapulothoracic. They have treated 37 years old patient who suffer from bursitis with pain and crepitus. They have used arthroscopy procedure. The first publication about scapulothoracic arthroscopy was in 1992. The method has been written very rarely by foreigner authors in medical journals.
Collapse
Affiliation(s)
- Jacek Mazek
- Klinika Ortopedii, Specjalistyczny Publiczny Szpital Kliniczny im. prof Adama Grucy w Otwocku
| | | | | |
Collapse
|