Dataset Information

Arthroscopic Fixation of Os Acetabuli and Labral Repair: Suture-on-Screw Technique.

ABSTRACT: Os acetabuli is thought to be the result of an unfused ossification center or an acetabular rim fracture in the setting of femoral-sided femoroacetabular impingement syndrome. Historically, patients with symptomatic hips have been treated with resection alone; however, in patients with large bone fragments or with reduced acetabular coverage prior to surgical intervention, iatrogenic dysplasia and structural instability may develop after resection. Therefore, for patients with an acetabular os, labral tearing, and cam-type femoroacetabular impingement, internal fixation of the os acetabuli, femoral osteochondroplasty, and labral repair have been described. We propose a "suture-on-screw" arthroscopic technique to simultaneously address both the labral tear and os acetabuli, thereby reducing the number of suture anchors required for labral fixation, leading to an efficient and cost-effective approach for the treatment of these patients.

SUBMITTER: DeFroda SF

PROVIDER: S-EPMC8252835 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

Arthroscopic Fixation of Os Acetabuli and Labral Repair: Suture-on-Screw Technique.

DeFroda Steven F SF Wichman Daniel D Browning Robert R Alter Thomas D TD Nho Shane J SJ

Arthroscopy techniques 20210507 6

Os acetabuli is thought to be the result of an unfused ossification center or an acetabular rim fracture in the setting of femoral-sided femoroacetabular impingement syndrome. Historically, patients with symptomatic hips have been treated with resection alone; however, in patients with large bone fragments or with reduced acetabular coverage prior to surgical intervention, iatrogenic dysplasia and structural instability may develop after resection. Therefore, for patients with an acetabular os, ...[more]

PMID: 34258195

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Project description:PurposeTo investigate whether os acetabuli identified preoperatively influence functional outcomes 2 years after an arthroscopic acetabular labral reconstruction.MethodsRetrospective study with prospectively collected data of patients undergoing primary hip arthroscopy by a single, fellowship-trained surgeon at a single institution were retrospectively reviewed. Inclusion criteria included age ≥18 years and completion of patient-reported outcome measures (PROMs) preoperatively and at 3-month, 6-month, 12-month, and last follow-up timepoints. Exclusion criteria included labral debridement, hip dysplasia, advanced hip osteoarthritis (Tonnis >1), or previous surgery on the ipsilateral hip. Patients were divided into two cohorts based on the presence of os acetabuli (OA) or the absence of os acetabuli (NOA). Primary outcomes collected included the International Hip Outcome Tool (iHOT-33) and modified Harris Hip Score (mHHS). Secondary outcomes were the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale, Non-Arthritic Hip Score, and visual analog pain scale. Inter-cohort outcomes were compared using linear mixed-effects and Fisher's exact tests. Nonlinear improvement trajectories were accounted for by sensitivity analyses.Results193 hips (49.2% female; mean ± SD age: 35.9 ± 11.0) were included in the final analyses. Of these, 25 (13.0%) had an os acetabulum. No significant differences between patients with and without os acetabuli were found throughout the minimum 2-year follow-up period in terms of iHOT-33 scores (weighted difference: 0.09; 95% CI: -6.81, 6.98; P = .98), mHHS (weighted difference: 2.93; 95% CI: -2.13, 7.98; P = .26), or any secondary outcomes. Additionally, there were no significant differences in any queried clinically meaningful outcomes (P > .05 for all), revision arthroscopy (P =.342), rates of formation of heterotopic ossification (p > .999), or conversion to total hip arthroplasty (P > .999). These results were upheld across sensitivity analyses.ConclusionsPatients with os acetabuli undergoing arthroscopic labral reconstruction had similar 2-year functional outcomes compared to those without os acetabuli.Level of evidenceLevel III, Retrospective cohort study.

Dataset Information

Arthroscopic Fixation of Os Acetabuli and Labral Repair: Suture-on-Screw Technique.

Publications

Arthroscopic Fixation of Os Acetabuli and Labral Repair: Suture-on-Screw Technique.

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