Surgical Technique: Arthroscopic Rectus Autograft
The importance of the acetabular labrum has been well documented for the health and function of the hip joint. Absence of the labrum through degeneration or injury and excision in an open or arthroscopic procedure has shown to cause continued pain as well as progressive destruction of the joint. The iliotibial band, harvested as a free graft, has most commonly been used to substitute for damaged or diseased labri; however, it requires a separate incision and may leave a defect in the fascia lata which may be bothersome to some patients. Fascia lata free grafts also require back table preparation and placement of sutures to create a tube graft. An alternative technique using the indirect head of the rectus femoris has been used on over 30 patients for intercalary labral grafts and provides an alternate technique in which the graph is harvested and repaired to the acetabular rim through the same arthroscopic portals. It is present in 100% of index hip surgeries, and sacrifice does not cause any significant dysfunction to the hip. An additional advantage is that it remains vascularized if left attached distally.