Purpose: Recently, arthroscopic repair has been advocated for the treatment of labral tears.
The purpose of this study was to document the histologic healing process in an arthroscopically
repaired acetabular-labral detachment in an ovine model. Methods: A total of 10 skeletally mature female sheep underwent unilateral arthroscopic labral
repair. A 1.5-cm-long incision was made at the junction of the labrum and acetabulum.
The labral detachment was then repaired arthroscopically with a single suture anchor.
Postoperatively, the animals were confined to small indoor pens, and no form of immobilization
was used. After 12 weeks, the animals were killed and the labral repair evaluated
via routine histology. Normal labra from 3 nonoperative animals were also processed
for histology. Results: The acetabular labrum of the sheep is an avascular, fibrocartilaginous structure
similar in anatomic design to that of human beings. All arthroscopically repaired
labra appeared stable and grossly healed at 12 weeks. Histologically, labral healing
appeared to occur via fibrovascular scar tissue originating from the joint capsule
or the exposed bony attachment of the labrum (or both). However, the labral healing
was incomplete in all specimens, with a shallow, superficial cleft remaining at the
junction of the labrum and the articular surface of the acetabulum. Conclusions: Arthroscopically repaired acetabular-labral lesions in sheep are capable of healing
via fibrovascular repair tissue or direct reattachment via new bone formation (or
both). Clinical Relevance: The ability of labral detachments to heal in this animal model provides the rationale
for additional investigations into the clinical efficacy of arthroscopic labral repair
in human beings.
Key Words
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References
- Acetabular labrum tears: A cause of hip pain and degenerative arthritis.South Med J. 1977; 70: 174-175
- Labral lesions: An elusive source of hip pain case reports and literature review.Arthroscopy. 1996; 12: 603-612
- Arthroscopic labral repair in the hip: Surgical technique and review of the literature.Arthroscopy. 2005; 21: 1496-1504
- A new method for acetabular rim trimming and labral repair.Clin Sports Med. 2006; 25: 293-297
- Femoroacetabular impingement: A cause for osteoarthritis of the hip.Clin Orthop Relat Res. 2003; : 112-120
- Arthroscopic capsulorrhaphy of the hip: A review of 12 cases.Arthroscopy. 2000; 16 (abstr): 416
- The role of arthroscopic thermal capsulorrhaphy in the hip.Clin Sports Med. 2001; 20: 817-829
- Hip arthroscopy in the presence of dysplasia.Arthroscopy. 2003; 19: 1055-1060
- The torn acetabular labrum.J Bone Joint Surg Br. 1986; 68: 400-403
- The role of labral lesions to development of early degenerative hip disease.Clin Orthop Relat Res. 2001; : 25-37
- The watershed labral lesion: Its relationship to early arthritis of the hip.J Arthroplasty. 2001; 16: S81-S87
- Hip arthroscopy for acetabular labral tears.Arthroscopy. 1999; 15: 132-137
- Acetabular labrum tears.Clin Orthop Relat Res. 1995; : 60-68
- The role of the acetabular labrum and the transverse acetabular ligament in load transmission in the hip.J Bone Joint Surg Am. 1998; 80: 1781-1788
- The acetabular labrum seal: A poroelastic finite element model.Clin Biomech. 2000; 15: 463-468
- The influence of the acetabular labrum on hip joint cartilage consolidation: A poroelastic finite element model.J Biomech. 2000; 33: 953-960
- An in vitro investigation of the acetabular labral seal in hip joint mechanics.J Biomech. 2003; 36: 171-178
- Treatment of femoro-acetabular impingement: Preliminary results of labral refixation.J Bone Joint Surg Am. 2006; 88: 925-935
- Repair of the adult acetabular labrum.Arthroscopy. 2006; 22 (567.e1-567.3. Available online at www.arthroscopyjournal.org)
- Anatomy, histologic features, and vascularity of the adult acetabular labrum.Clin Orthop Relat Res. 2001; : 232-240
- Structure and vascularization of the acetabular labrum with regard to the pathogenesis and healing of labral lesions.Arch Orthop Trauma Surg. 2003; 123: 283-288
- The vascularity of the hip labrum: A cadaveric investigation.Arthroscopy. 2005; 21: 3-11
- Microvasculature of the human meniscus.Am J Sports Med. 1982; 10: 90-95
- The microvasculature of the meniscus and its response to injury.Am J Sports Med. 1983; 11: 131-141
- Effects of removal of the acetabular labrum in a sheep hip.Osteoarthritis Cartilage. 2004; 12: 419-430
- Tendon healing in a bone tunnel: A biomechanical and histological study in the dog.J Bone Joint Surg Am. 1993; 75: 1795-1803
Article info
Footnotes
Supported by Smith & Nephew Endoscopy. Research performed at Colorado State University, Fort Collins, Colorado, and Michigan State University, East Lansing, Michigan. Drs. Philippon and Arnoczky are paid consultants for Smith & Nephew Endoscopy, and Mr. Torrie is an employee of Smith & Nephew Endoscopy.
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Copyright
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
