Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (5): 1007-1011. doi: 10.19723/j.issn.1671-167X.2021.05.033

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Arthroscopic labrum reconstruction for femoroacetabular impingement syndrome: 12 cases report

DONG Han-mei,WU Rui-qi,GAO Guan-ying,LIU Rong-ge,XU Yan()   

  1. Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
  • Received:2021-06-15 Online:2021-10-18 Published:2021-10-11
  • Contact: Yan XU E-mail:yanxu@139.com

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Abstract:

To investigate the surgical effect of hip arthroscopic labrum reconstruction. A retrospective study was performed on the clinical data of 12 patients who underwent hip arthroscopic labrum reconstruction in our department from September 2017 to February 2021 and were followed up for 5-46 months, with an average of 21.5 months. All the patients had a hip joint space of more than 2 mm, and Tonnis grade less than level Ⅱ. These 12 patients underwent arthroscopic debridement of hyperplastic synovium, femoral head and neck and/or acetabular osteoplasty, and labrum reconstruction using autograft iliotibial band or gracilis tendon. After the surgery, we conducted follow-up and data collection, recorded the satisfaction of the patients and occurrence of complications, as well as the cartilage lesion of hip joint observed under the arthroscopy. We compared the alpha angle of Dunn X-ray film, center-edge angle (CE angle) of AP X-ray film, modified Harris hip score (mHHS score), hip outcome score (HOS), international hip outcome tool 12 score (iHOT12 Score), and visual analogue scale (VAS scale) before and after the arthroscopic operation, to assess clinical symptom relief and joint function recovery. The 12 patients were followed up for 5-46 (21.5±12.8) months. The VAS scale were (5.3±2.5) and (2.5±1.4) before and after the surgery, showing significant decrease (P=0.018). The mHHS score were (60.6±22.2) and (83.1±5.8) before and after the surgery, showing significant increase (P=0.003). The patient satisfaction was high (7.8±2.0) (range: 0-10). None of the 12 patients had serious complications, revision surgery, or total hip replacement at the end of the last follow-up. Autologous tendon transplantation for reconstruction of acetabular labrum under arthroscopy can improve the clinical symptoms and joint function of patients with femoroacetabular impingement (FAI), which is a safe and effective treatment.

Key words: Femoroacetabular impingment, Hip injuries, Arthroscopes, Transplantation, autologous

CLC Number: 

  • R687.4

Table 1

Patients demographics"

Items Data
Number of patients, n 12
Mean age at surgery/years 35.7 (22-49)a
Female ∶Male, n 3 ∶9
Mean body mass index 21.8 (16.5-27.5)a
Side affected (left ∶right), n 5 ∶7
Symptom onset/months 44.2 (8-100)a
Follow-up/months 21.5 (5-46)a
Follow-up/% 100

Figure 1

Labrum lesion"

Figure 2

Labrum defect Figure 3 Pincer osteotomy Figure 4 Measurement of labrum defect Figure 5 Autograft Figure 6 Anchor to acetabular margin Figure 7 Recovery of labrum sealing effect"

Table 2

Improvement of hip function and symptoms before and after surgery"

Items Preoperative, x ?±s Postoperative, x ?±s P value
α angle/(°) 71.7±9.8 50.2±6.1 0.002
CE angle/(°) 37.5±5.2 35.9±3.6 0.099
mHHS 60.6±22.2 83.1±5.8 0.003
HOS-ADL 87.0±6.6 91.8±4.6 0.018
HOS-SS 80.1±14.0 88.7±4.0 0.009
iHOT-12 77.2±11.3 88.8±6.1 0.012
VAS 5.3±2.5 2.5±1.4 0.018

Table 3

Arthroscopic findings"

Items n (%)
Labral lesions 12 (100.0)
Cam-type impingement 3 (25.0)
Pincer-type impingement 0
Mixed-type impingement 9 (75.0)
Acetabular cartilage damage
(Outerbridge classification)
0 4 (33.3)
1 0
2 1 (8.3)
3 1 (8.3)
4 6 (50.0)
Femoral cartilage damage
(Outerbridge classification)
0 12 (100.0)
1-4 0

Figure 8

Autograft in-place in MRI follow-up"

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