ARTHROSCOPIC TREATMENT OF FEMOROACETABULAR IMPINGEMENT USING LABRAL RECONSTRUCTION WITH CAPSULAR AUTOGRAFT
The acetabular labrum is essential for stability during physiologic motion of the hip. Labral repairs frequently are attempted in cases of primary tears, although labral reconstruction is an important alternative in the revision setting or in the primary setting when the tissue is unsalvageable. Labral reconstruction has been shown to restore the hip’s suction-seal and fluid pressurization to that of the premorbid state, and cohort studies have demonstrated significantly improved patient-reported outcomes at midterm follow-up. Notably, the cost is of consideration during any reconstruction, and techniques have been described using both allograft and autograft sources. Autograft sources include the iliotibial band, ligamentum teres, gracilis tendon, and hip capsule. A previously described technique using the capsule was noted to hinder routine capsular closure. We present an alternative method for labral reconstruction using hip capsular tissue that is easily performed and allows for routine capsular closure.
Hip labral reconstruction via capsular autograft is an effective technique when a labral deficiency is encountered, both in the primary and revision setting. The present technique describes our preferred method of capsular autograft harvest, preparation, and implantation (Table 1).
The present technique is advantageous because it does not require an additional incision or graft harvest to perform, and it uses the patients’ capsular tissue for labral reconstruction or augmentation (Table 2).
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Published September 21, 2022 in Arthroscopic Techniques.