Do iatrogenic punctures of the labrum affect the clinical results of hip arthroscopy?
ABSTRACT To document the effect of iatrogenic labral punctures (ILPs) on the clinical results of hip arthroscopy.
From a database of 250 consecutive patients who had their hip arthroscopy performed by the senior author, 50 patients with ILPs were identified. Results of hip arthroscopy in these patients were compared with those of a matched group of 50 patients who did not have labral puncture (NLP). All hips were assessed with Byrd's 100-point modified Harris hip scoring system before arthroscopy and at 3, 6, 12, and 24 months after surgery.
The mean age of the ILP and NLP patients was 40 and 36 years, respectively, and their preoperative scores averaged 36 points. Mean joint distraction was 13 mm and 15 mm in the ILP and NLP patients, respectively, and a positive "Byrd's sign" was seen in both the ILP (84%) and NLP (42%) patients. After surgery, the ILP and NLP patients had 6-month scores that averaged 85 and 88 points, respectively. At 12 months, their scores averaged 88 and 90 points, respectively, and after 24 months, their scores averaged 88 and 89 points, respectively. At all follow-up intervals, there were no significant differences between the scores of the 2 groups (P > .05).
ILPs did not affect the 1- and 2-year clinical results of patients who sustained these injuries during hip arthroscopy.
Level III, case-control study.
- SourceAvailable from: europepmc.org[show abstract] [hide abstract]
ABSTRACT: Over recent years hip arthroscopic surgery has evolved into one of the most rapidly expanding fields in orthopaedic surgery. Complications are largely transient and incidences between 0.5% and 6.4% have been reported. However, major complications can and do occur. This article analyses the reported complications and makes recommendations based on the literature review and personal experience on how to minimise them.Bone & joint research. 07/2012; 1(7):131-44.
- [show abstract] [hide abstract]
ABSTRACT: Intraoperative labral injury during the establishment of the first portal in hip arthroscopy has been reported to be as high as 20%. The purpose of the study was to prospectively identify the incidence of acetabular labral injuries that occurred while using a current technique for the establishment of portals during hip arthroscopy. Case series; Level of evidence, 4. Between the years 2008 and 2010, data were prospectively collected for all patients undergoing hip arthroscopic surgery. Patients with previous labral resection or Tonnis grade greater than 1 were excluded. Patients were positioned supine, traction was applied, and portals were established. The anterolateral portal was created first by venting the joint with a spinal needle and then re-entering the joint with the same needle with the bevel side facing the labrum. Next, the midanterior portal was created under vision. A thorough examination of the acetabular labrum was conducted arthroscopically through multiple viewing portals, and labral injuries related to the establishment of portals were identified and noted. A total of 300 patients were included in the study; only 2 patients (0.67%) suffered intraoperative labral injuries at the study period. One injury occurred during revision arthroscopy, while the second involved a hyperplastic labrum in a dysplastic hip. No patient with normal hip morphological characteristics undergoing a hip arthroscopy suffered a labral tear as a result of portal placement. The incidence of iatrogenic labral injury during hip arthroscopy can be as low as 0.67% when using the described technique.The American journal of sports medicine 02/2012; 40(4):864-9. · 3.61 Impact Factor