Document Detail


Treatment of femoro-acetabular impingement: preliminary results of labral refixation.
MedLine Citation:
PMID:  16651565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent advances in the understanding of the anatomy and function of the acetabular labrum suggest that it is important for normal joint function. We found no available data regarding whether labral refixation after treatment of femoro-acetabular impingement affects the clinical and radiographic results. METHODS: We retrospectively reviewed the clinical and radiographic results of fifty-two patients (sixty hips) with femoro-acetabular impingement who underwent arthrotomy and surgical dislocation of the hip to allow trimming of the acetabular rim and femoral osteochondroplasty. In the first twenty-five hips, the torn labrum was resected (Group 1); in the next thirty-five hips, the intact portion of the labrum was reattached to the acetabular rim (Group 2). At one and two years postoperatively, the Merle d'Aubigné clinical score and the Tönnis arthrosis classification system were used to compare the two groups. RESULTS: At one year postoperatively, both groups showed a significant improvement in their clinical scores (mainly pain reduction) compared with their preoperative values (p = 0.0003 for Group 1 and p < 0.0001 for Group 2). At two years postoperatively, 28% of the hips in Group 1 (labral resection) had an excellent result, 48% had a good result, 20% had a moderate result, and 4% had a poor result. In contrast, in Group 2 (labral reattachment), 80% of the hips had an excellent result, 14% had a good result, and 6% had a moderate result. Comparison of the clinical scores between the two groups revealed significantly better outcomes for Group 2 at one year (p = 0.0001) and at two years (p = 0.01). Radiographic signs of osteoarthritis were significantly more prevalent in Group 1 than in Group 2 at one year (p = 0.02) and at two years (p = 0.009). CONCLUSIONS: Patients treated with labral refixation recovered earlier and had superior clinical and radiographic results when compared with patients who had undergone resection of a torn labrum. Although the results must be considered preliminary, we now recommend refixation of the intact portion of the labrum after trimming of the acetabular rim during surgical treatment of femoro-acetabular impingement.
Authors:
Norman Espinosa; Dominique A Rothenfluh; Martin Beck; Reinhold Ganz; Michael Leunig
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  88     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-02     Completed Date:  2006-06-06     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  925-35     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, University of Berne, Inselspital, Switzerland. norman.espinosa@balgrist.ch
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MeSH Terms
Descriptor/Qualifier:
Acetabulum*
Adult
Cartilage, Articular / pathology,  radiography,  surgery*
Female
Femur*
Follow-Up Studies
Hip Joint / pathology,  radiography,  surgery*
Humans
Joint Diseases / pathology,  radiography,  surgery*
Male
Range of Motion, Articular
Retrospective Studies
Treatment Outcome
Comments/Corrections
Comment In:
J Bone Joint Surg Am. 2006 Nov;88(11):2537; author reply 2537-8   [PMID:  17079420 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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