PMID- 34664420
OWN - NLM
STAT- MEDLINE
DCOM- 20211122
LR  - 20211122
IS  - 1757-7861 (Electronic)
IS  - 1757-7853 (Print)
IS  - 1757-7853 (Linking)
VI  - 13
IP  - 6
DP  - 2021 Aug
TI  - Microfracture of Acetabular Rim After Segmental Labral Resection to Restore the 
      Morphology and Function of Labrum: A Retrospective Study of More than 2 Years 
      Follow-up.
PG  - 1853-1862
LID - 10.1111/os.13131 [doi]
AB  - OBJECTIVE: To report on the clinical outcome of patients undergoing combined 
      arthroscopic treatment of labral resection and microfracture at the rim of 
      acetabulum at a minimum 2-year follow-up. METHODS: The retrospective study 
      included 38 patients undergoing hip arthroscopy for irreparable labral injury 
      from 24 February 2014 to 26 February 2018. Thirteen patients were excluded owing 
      to patient refusal of participation and concomitant diseases like synovial 
      chondromatosis and dysplasia hip. The study group consisted of patients 
      undergoing combined arthroscopic labral resection and microfracture at the rim of 
      acetabulum (MICRO Group: 20 patients), arthroscopic labral resection alone (RESEC 
      Group: five patients). Postoperative three-dimensional (3D) double-echo 
      steady-state (DESS) sequence with radial imaging at 3 Tesla were obtained and 
      fluoroscopic image of the involved hip under distraction were used to observe the 
      restoration of vacuum effect. Patient-reported outcome scores (PROs) including 
      the Harris Hip Score (HHS), Visual Analogue Score (VAS), Hip Outcome Score 
      Activities of Daily Living Subscale (HOS-ADL), Hip Outcome Score Sport-Specific 
      Subscale (HOS-SSS) were collected and compared between two groups. RESULTS: All 
      patients were followed up for at least 6 months. The follow-up time of RESEC 
      group is longer than MICRO group (46.6 months vs 23.9 months, P < 0.05). The 3D 
      DESS imaging demonstrated intermediate signal intensity at the relative area 
      where the labrum resected followed by microfracture at the acetabular rim in 
      MICRO group. Meanwhile, regrowth of labrum-like tissue was not observed in MRI 
      imaging of the RESEC group. Furthermore, vacuum effect was more apparent in MICRO 
      group compared with RESEC group. All PROs in both groups showed a statistically 
      significant improvement at follow-up compared with preoperative levels. RESEC 
      group: HHS (73.0 vs 93.8, P < 0.05); HOS-ADL (51.5 vs 89.1, P < 0.05); HOS-SSS 
      (47.8 vs 88.3, P < 0.05); VAS (6.4 vs 2.0, P < 0.05). MICRO group: HHS (70.5 vs 
      91.5, P < 0.05); HOS-ADL (52.4 vs 87.0, P < 0.05); HOS-SSS (48.1 vs 86.5, P 
      < 0.05); VAS (6.3 vs 1.6, P < 0.05). One patient of MICRO group had transient 
      neurapraxias of the pudendal nerve that resolved completely by 3 months. There 
      showed no statistically significant difference between groups regarding the 
      preoperative and postoperative PROs. CONCLUSION: Compared to labral resection, 
      combined arthroscopic labral resection and microfracture at the rim of acetabulum 
      is able to fulfill the labral defect area with the potential to restore the seal 
      effect of labrum as an effective and safe option for irreparable segmental labral 
      tears.
CI  - (c) 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic 
      Association and John Wiley & Sons Australia, Ltd.
FAU - Su, Tiao
AU  - Su T
AD  - Center for Joint Surgery, Army Medical University, Chongqing, China.
FAU - Li, Jing
AU  - Li J
AD  - Radiology Department, Southwest Hospital, Army Medical University, Chongqing, 
      China.
FAU - Yang, Liu
AU  - Yang L
AD  - Center for Joint Surgery, Army Medical University, Chongqing, China.
FAU - Chen, Guang-Xing
AU  - Chen GX
AD  - Center for Joint Surgery, Army Medical University, Chongqing, China.
LA  - eng
GR  - 2020MSXM054/Joint Project of Chongqing Science and Technology Commission/
GR  - SWH2016JSTSYB-54/New Clinical Technology Program of the First Affiliated Hospital 
      of Army Medical University/
GR  - CX2019JS202/New Technology Cultivation Project of Military Medicine/
GR  - SWH2019BJLC-01/Young Talent Training Program/
PT  - Journal Article
PL  - Australia
TA  - Orthop Surg
JT  - Orthopaedic surgery
JID - 101501666
SB  - IM
MH  - Acetabulum/*surgery
MH  - Adult
MH  - Arthroscopy/*methods
MH  - Cartilage, Articular/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - *Fractures, Stress
MH  - Hip Injuries/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Patient Reported Outcome Measures
MH  - Retrospective Studies
PMC - PMC8523766
OTO - NOTNLM
OT  - 3D DESS
OT  - Hip arthroscopy
OT  - Irreparable labral lesion
OT  - Marrow stimulation
OT  - Microfracture
EDAT- 2021/10/20 06:00
MHDA- 2021/11/23 06:00
PMCR- 2021/10/18
CRDT- 2021/10/19 06:44
PHST- 2021/05/26 00:00 [revised]
PHST- 2021/01/15 00:00 [received]
PHST- 2021/06/22 00:00 [accepted]
PHST- 2021/10/19 06:44 [entrez]
PHST- 2021/10/20 06:00 [pubmed]
PHST- 2021/11/23 06:00 [medline]
PHST- 2021/10/18 00:00 [pmc-release]
AID - OS13131 [pii]
AID - 10.1111/os.13131 [doi]
PST - ppublish
SO  - Orthop Surg. 2021 Aug;13(6):1853-1862. doi: 10.1111/os.13131.