PMID- 25367017
OWN - NLM
STAT- MEDLINE
DCOM- 20150528
LR  - 20220318
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 43
IP  - 1
DP  - 2015 Jan
TI  - Arthroscopic acetabuloplasty and labral refixation without labral detachment.
PG  - 105-12
LID - 10.1177/0363546514555330 [doi]
AB  - BACKGROUND: Arthroscopic acetabuloplasty was initially described with detachment 
      of the labrum to access the acetabular rim for resection, followed by labral 
      refixation. Recent technical improvements have made it possible to perform 
      acetabuloplasty and labral refixation without labral detachment when the 
      chondrolabral junction is intact. PURPOSE: To compare outcomes for patients 
      undergoing arthroscopic acetabuloplasty and labral refixation without labral 
      detachment (study group), as well as compare this with a group of patients who 
      underwent acetabuloplasty with labral refixation and labral detachment (control 
      group) with a minimum 2-year follow-up. STUDY DESIGN: Cohort study; Level of 
      evidence, 3. METHODS: During the study period, data were prospectively collected 
      on all patients treated with hip arthroscopy. Inclusion criteria for the study 
      group were acetabuloplasty and labral refixation without detachment, performed in 
      cases with an intact chondrolabral junction. Patients were then compared with a 
      control group of patients who had acetabuloplasty with labral detachment and 
      refixation. All patients were assessed pre- and postoperatively using 4 
      patient-reported outcome (PRO) measures and a visual analog scale (VAS) for pain, 
      as well as monitored for revision surgery. RESULTS: In the study group, the 
      preoperative to postoperative score changed from 64.2 to 86.6 for modified Harris 
      Hip Score (mHHS), 60.5 to 83.8 for Nonarthritic Hip Score (NAHS), 65.3 to 87.3 
      for Hip Outcome Score-Activity of Daily Living (HOS-ADL), 45 to 75.1 for Hip 
      Outcome Score-Sport-Specific Subscale (HOS-SSS), and 5.7 to 2.6 for VAS. In the 
      control group, the preoperative to postoperative score changed from 61.2 to 84.4 
      for mHHS, 59 to 84 for NAHS, 62.7 to 86.2 for HOS-ADL, 40.1 to 74.1 for HOS-SSS, 
      and 6.3 to 2.8 for VAS. There was no difference between preoperative and 
      postoperative PRO scores. The preoperative VAS score was lower in the study group 
      than in the control group (P=.04). The control group demonstrated larger mean 
      preoperative anterior center edge angles (ACEA) (33.8 degrees  vs 29.5 degrees ) and mean alpha 
      angles (60.5 degrees  vs 53.5 degrees ) than the study group (P<.05). There was no statistically 
      significant difference in the change in PRO or VAS scores between groups. Both 
      groups demonstrated significant improvement from preoperative to 2-year follow-up 
      for all 4 PRO scores (P<.05) and decrease in VAS (P<.05). One patient in the 
      study group converted to total hip arthroplasty. Seven patients underwent 
      revision hip arthroscopy in the study group, and 8 patients in the control group 
      underwent revision hip arthroscopy. There was no difference in revision rates 
      between groups. CONCLUSION: Treatment of pincer- and combined-type impingement 
      with arthroscopic acetabuloplasty and labral refixation without detachment, when 
      possible, resulted in similar patient outcomes compared with acetabuloplasty with 
      labral detachment. We may conclude that in cases where the chondrolabral junction 
      remains intact, acetabuloplasty and labral refixation without detachment is a 
      viable option.
CI  - (c) 2014 The Author(s).
FAU - Redmond, John M
AU  - Redmond JM
AD  - Hinsdale Orthopaedics, American Hip Institute in Chicago, Westmont, Illinois, 
      USA.
FAU - El Bitar, Youssef F
AU  - El Bitar YF
AD  - Hinsdale Orthopaedics, American Hip Institute in Chicago, Westmont, Illinois, 
      USA.
FAU - Gupta, Asheesh
AU  - Gupta A
AD  - Hinsdale Orthopaedics, American Hip Institute in Chicago, Westmont, Illinois, 
      USA.
FAU - Stake, Christine E
AU  - Stake CE
AD  - Hinsdale Orthopaedics, American Hip Institute in Chicago, Westmont, Illinois, 
      USA.
FAU - Vemula, S Pavan
AU  - Vemula SP
FAU - Domb, Benjamin G
AU  - Domb BG
AD  - Hinsdale Orthopaedics, American Hip Institute in Chicago, Westmont, Illinois, USA 
      DrDomb@americanhipinstitute.org.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20141103
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
EIN - Am J Sports Med. 2015 Feb;43(2):NP1. Vemula, S Pavan [added]
EIN - Am J Sports Med. 2015 Feb;43(2):NP1. PMID: 28075169
MH  - Acetabuloplasty/*methods
MH  - Activities of Daily Living
MH  - Adult
MH  - Arthralgia/etiology
MH  - Arthroscopy/*methods
MH  - Female
MH  - Femoracetabular Impingement/complications/*surgery
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Reoperation
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - acetabuloplasty
OT  - femoroacetabular impingement
OT  - hip arthroscopy
OT  - hip labrum
OT  - labral detachment
OT  - labral refixation
OT  - labral repair
OT  - labral takedown
OT  - pincer impingement
EDAT- 2014/11/05 06:00
MHDA- 2015/05/29 06:00
CRDT- 2014/11/05 06:00
PHST- 2014/11/05 06:00 [entrez]
PHST- 2014/11/05 06:00 [pubmed]
PHST- 2015/05/29 06:00 [medline]
AID - 0363546514555330 [pii]
AID - 10.1177/0363546514555330 [doi]
PST - ppublish
SO  - Am J Sports Med. 2015 Jan;43(1):105-12. doi: 10.1177/0363546514555330. Epub 2014 
      Nov 3.