Advertisement

Surgical Technique: Open Hip HS Allograft

  • K. Corten
  • K. Carpentier
  • M. Leunig
Living reference work entry

Abstract

Femoroacetabular impingement is a well-known cause of hip pain. When impingement is caused by a relative over-coverage of the femoral head, it is called pincer impingement. A possible treatment option consists of rim trimming. Pincer impingement is often associated with labral thinning and degeneration. If the labrum is not repairable, a labral reconstruction is needed to restore labral function.

The preferred surgical technique for a circumferential labral reconstruction is an open reconstruction using a hamstring allograft. A surgical dislocation is performed according to the technique described by Ganz et al. After performing the rim trimming, a reconstruction of the labrum using a semitendinosus allograft is performed. This graft is prepared and then fixed to the rim using bone anchors from anterior to posterior. Both ends of the graft are also firmly fixed to the transverse acetabular ligament. This reconstruction ensures a 360° repair of the sealing function of the labrum.

References

  1. 1.
    Corten K, Ganz R, Chosa E, Leunig M. Bone apposition of the acetabular rim in deep hips: a distinct finding of global pincer impingement. J Bone Joint Surg Am. 2011;93 Suppl 2:10–6. Epub 2011/05/13.PubMedGoogle Scholar
  2. 2.
    Adeeb SM, Sayed Ahmed EY, Matyas J, Hart DA, Frank CB, Shrive NG. Congruency effects on load bearing in diarthrodial joints. Comput Methods Biomech Biomed Engin. 2004;7(3):147–57. Epub 2004/10/30.PubMedCrossRefGoogle Scholar
  3. 3.
    Ferguson SJ, Bryant JT, Ganz R, Ito K. An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomech. 2003;36(2):171–8. Epub 2003/01/28.PubMedCrossRefGoogle Scholar
  4. 4.
    Hlavacek M. The influence of the acetabular labrum seal, intact articular superficial zone and synovial fluid thixotropy on squeeze-film lubrication of a spherical synovial joint. J Biomech. 2002;35(10):1325–35. Epub 2002/09/17.PubMedCrossRefGoogle Scholar
  5. 5.
    Fredensborg N. The CE, angle of normal hips. Acta Orthop Scand. 1976;47(4):403–5. Epub 1976/08/01.PubMedCrossRefGoogle Scholar
  6. 6.
    Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Chir Scand. 1939;83:58.Google Scholar
  7. 7.
    Philippon MJ, Wolff AB, Briggs KK, Zehms CT, Kuppersmith DA. Acetabular rim reduction for the treatment of femoroacetabular impingement correlates with preoperative and postoperative center-edge angle. Arthroscopy. 2010;26(6):757–61. Epub 2010/06/01.PubMedCrossRefGoogle Scholar
  8. 8.
    Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg. 2001;83(8):1119–24. Epub 2002/01/05.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryZiekenhuis Oost-LimburgGenkBelgium
  2. 2.AZ St Blasius, DendermondeHeverleeBelgium
  3. 3.Department of Orthopaedic SurgerySchulthess KlinikZürichSwitzerland

Personalised recommendations