scholarly journals Arthroscopic Repair of a Circumferential 360° Labral Tear

2017 ◽  
Vol 6 (4) ◽  
pp. e1131-e1136 ◽  
Author(s):  
Allison J. Rao ◽  
Gregory L. Cvetanovich ◽  
William A. Zuke ◽  
Quentin Low ◽  
Brian Forsythe
Keyword(s):  
Arthroscopic Repair ◽  
Labral Tear

scholarly journals Comparative study on clinical results of arthroscopic repair of anteroinferior, superior, and combined glenoid labral tear

2018 ◽  
Vol 26 (1) ◽  
pp. 230949901876261 ◽  
Author(s):  
Meng Zhu ◽  
Jerry Yongqiang Chen ◽  
Hwei Chi Chong ◽  
Paul Chang Chee Cheng ◽  
Denny Lie Tijauw Tjoen
Keyword(s):  
Comparative Study ◽  
Clinical Results ◽  
Arthroscopic Repair ◽  
Labral Tear

Outcomes After Arthroscopic Repair in Patients With Tears of Hypertrophic Versus Morphologically Normal Acetabular Labra

2020 ◽  
Vol 48 (5) ◽  
pp. 1168-1174 ◽  
Author(s):  
Jae-Young Lim ◽  
Ye-Hoon Jang ◽  
Jun-Il Yoo ◽  
Young-Kyun Lee ◽  
Kyung-Hoi Koo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Scale Score ◽  
Arthroscopic Repair ◽  
Labral Tear ◽  
Cartilage Injury ◽  
Labral Tears ◽  
Acetabular Labral Tear ◽  
Patient Reported ◽  
And Cartilage

Background: Recently, a hypertrophic labrum has been reported in the absence of hip dysplasia, which can possibly contribute to an acetabular labral tear. Purpose: To compare the clinical outcomes and complications, including the incidence of iatrogenic acetabular labrum and cartilage injury, in patients with tears of hypertrophic versus morphologically normal acetabular labra over a minimum follow-up period of 2 years and to assess the morphologic changes at follow-up computed tomography arthrography in the 2 groups. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2010 and December 2016, 20 patients (22 hips) with a hypertrophic labrum underwent arthroscopic hip surgery. A total of 22 patients (22 hips) without a hypertrophic labrum were assigned to the control group based on matching criteria, including age, sex, body mass index, labral tear, and labral repair. Clinical outcomes were assessed with the visual analog scale score, UCLA activity scale score (University of California, Los Angeles), and modified Harris Hip Score. Radiologic outcomes were assessed through serial radiography. Patients were followed for at least 2 years. Results: The mean age at surgery was 42 years. The most common cause of arthroscopic surgery in the study group was an isolated acetabular labral tear without any bony structural abnormalities (68.2%, 15 of 22 hips). All improvements in both groups were statistically significant at the last postoperative follow-up ( P < .001). Although the radiologic and clinical outcomes were not significantly different between the groups, the complication rates, including iatrogenic labral perforations and cartilage injury, were significantly higher in patients with hypertrophic acetabular labral tears (9 vs 3, P = .042). The patient-reported satisfaction scores at the last postoperative follow-up were 8.4 and 7.9 in the study and control groups, respectively ( P = .351). Conclusion: The high rates of patient-reported satisfaction and the clinical outcomes after arthroscopic repair in both groups are encouraging. Arthroscopic treatment in patients with hypertrophic acetabular labral tears should be carefully performed to prevent iatrogenic injury during the surgery, and isolated hypertrophic labral tears can have good results after repair.

scholarly journals Arthroscopic Repair of a Posterior Midcapsular Rupture Causing Posterior Shoulder Instability

2021 ◽  
Vol 1 (6) ◽  
pp. 263502542110319
Author(s):  
Gautam P. Yagnik ◽  
Kevin West ◽  
Bhavya K. Sheth ◽  
Luis Vargas ◽  
John W. Uribe
Keyword(s):  
Shoulder Instability ◽  
Arthroscopic Repair ◽  
Labral Tear ◽  
Labral Repair ◽  
Posterior Capsule ◽  
Posterior Shoulder Instability ◽  
Posterior Instability ◽  
Difficult Condition ◽  
Posterior Shoulder ◽  
Diagnostic Arthroscopy

Background: Gross posterior instability is rare and when found likely has an injury or deficiency to the posterior static restraints of shoulder associated with it. Traditionally, injuries to the posterior capsule have been difficult to diagnose and visualize with magnetic resonance imaging preoperatively, and very little literature regarding arthroscopic repair of posterior capsular tears exists currently. Indications: We present a repair of a posterior midcapsular and posterior labral tear in a 26-year-old man with recurrent left posterior shoulder instability using a novel all–arthroscopic technique. Technique Description: We performed a shoulder arthroscopy in a lateral decubitus position with the arm at 45° of abduction using standard posterior viewing and anterior working portals. Diagnostic arthroscopy revealed a large posterior midcapsular rupture approximately 2 cm lateral to the glenoid with an associated posterior labral tear. We created an accessory posterolateral portal with needle localization that was outside the capsular defect yet allowed access to the posterior labrum. Anatomic closure of the capsular tear was achieved arthroscopically with 3 interrupted No. 2 nonabsorbable sutures in a side–to–side fashion. Posterior labral repair and capsular shift were done to further address the instability using 2 knotless all–suture anchors percutaneously placed at the 7 o'clock and 9 o'clock position. We closed the posterior portal with a combination of curved and penetrating suture passers. Incisions were closed with interrupted 4-0 nylon. Postoperatively, the patient was placed in an ultra–sling for 4 weeks before physical therapy. We allowed light strengthening at 8 weeks, full strengthening at 12 weeks, and estimated return to sport at 4 months. Results: At 6 months postoperatively, the patient has regained symmetric motion, full strength, and has no residual pain or instability. Conclusion: Gross posterior instability is a rare and difficult condition to diagnose and manage. If no significant labral injuries are identified, injury to the posterior capsule must be considered and full assessment should be done when visualizing from the anterior portal. Repair of the posterior capsule is necessary and can be achieved all arthroscopically with this technique.

Arthroscopic Repair of the Hip Abductor Musculotendinous Unit: The Effect of Microfracture on Clinical Outcomes

2021 ◽  
pp. 036354652199967
Author(s):  
Baris Kocaoglu ◽  
Ahmet Emre Paksoy ◽  
Simone Cerciello ◽  
Matthieu Ollivier ◽  
Romain Seil ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Surgical Repair ◽  
Gluteus Medius ◽  
Arthroscopic Repair ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Outcome Score ◽  
Significant Difference ◽  
Hip Abductor ◽  
Tendon Tears

Background: Endoscopic surgical repair has become a common procedure for treating patients with hip abductor tendon tears. Considering that retear rates are high after the repair of gluteus medius and minimus tendons, exploring alternative strategies to enhance structural healing is important. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of adding microfracture to single-row repair (SR) on outcomes after the surgical repair of gluteus medius and minimus tendons and compare with SR and double-row repair (DR) without microfracture. We hypothesized that microfracture of the trochanteric footprint with SR would lead to superior clinical outcomes and lower clinically evident retear rates compared with SR and DR without the addition of microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 50 patients who underwent primary arthroscopic repair of hip gluteus medius and minimus tendon tears were investigated. Patients were divided into 3 groups: DR, 16 patients; SR, 14 patients; and SR with microfracture (SRM), 20 patients. Patients were evaluated with a visual analog scale (VAS) for pain as well as the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport Specific (HOS-SS), and modified Harris Hip Score (mHHS) both preoperatively and at a minimum 2-year follow-up (mean, 30 months). Results: Among the SR, SRM, and DR groups, the greatest decrease in VAS scores and increase in mHHS, HOS-ADL, and HOS-SS scores were seen in the SRM group, and all the differences were significant ( P < .001 to P = .006). The abductor tendon retear rates were 31.3%, 35.7%, and 15.0% in the DR, SR, and SRM groups, respectively. Retear rates were lower in the SRM group compared with the SR and DR groups ( P = .042); however, there was no significant difference between the SR and DR groups ( P = .32) in terms of retear rates. Conclusion: Endoscopic SR with microfracture was a safe, practical, and effective technique and had the potential advantage of enhancing biological healing at the footprint. The addition of microfracturing the trochanteric footprint significantly lowered the retear rate and provided better functional outcomes than SR and DR without microfracture.

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