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Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration of Femoroacetabular Contact Biomechanics
BACKGROUND: Many advances have been made in hip labral repair and reconstruction and in the restoration of the suction seal. PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the biomechanical effects of segmental labral reconstruction with a synthetic polyurethane scaffold (PS) in compa...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478710/ https://www.ncbi.nlm.nih.gov/pubmed/36119123 http://dx.doi.org/10.1177/23259671221118831 |
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author | Capurro, Bruno Reina, Francisco Carrera, Anna Monllau, Joan Carles Marqués-López, Fernando Marín-Peña, Oliver Torres-Eguía, Raúl Tey-Pons, Marc |
author_facet | Capurro, Bruno Reina, Francisco Carrera, Anna Monllau, Joan Carles Marqués-López, Fernando Marín-Peña, Oliver Torres-Eguía, Raúl Tey-Pons, Marc |
author_sort | Capurro, Bruno |
collection | PubMed |
description | BACKGROUND: Many advances have been made in hip labral repair and reconstruction and in the restoration of the suction seal. PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the biomechanical effects of segmental labral reconstruction with a synthetic polyurethane scaffold (PS) in comparison with segmental labrectomy. Our hypothesis was that reconstruction with a icroporous polyurethane implant would normalize joint kinetics of the hip and restore the suction seal. STUDY DESIGN: Controlled laboratory study. METHODS: We used 10 hips from 5 fresh-frozen pelvises with an intact acetabular labrum without osteoarthritis. Using an intra-articular pressure measurement system, the contact area, contact pressure, and peak force were assessed for the following conditions: intact labrum, partial anterosuperior labrectomy, and PS reconstruction. For each condition, all specimens were analyzed in 4 positions (90° of flexion, 90° of flexion and internal rotation, 90° of flexion and external rotation, and 20° of extension) and underwent a labral seal test. The relative change from the intact condition was determined for all conditions and positions. RESULTS: Compared with the intact labrum, labrectomy resulted in a significant decrease in the contact area (P < .001) and a significant increase in the peak force (P < .001) and contact pressure (P < .001) across all positions. Compared with labrectomy, PS reconstruction resulted in a significant increase in the contact area (P < .001) and a significant decrease in the contact pressure (P ≤ .02) and peak force (P < .001) across all positions. Compared with the intact labrum, PS reconstruction restored the contact area and peak force to normal values in all positions (P > .05), whereas the contact pressure was significantly decreased compared with labrectomy (P < .05) but did not return to normal values. The labral seal was lost in all specimens after labrectomy but was restored in 80% of the specimens after PS reconstruction. CONCLUSION: Femoroacetabular contact biomechanics significantly worsened after partial labrectomy; reconstruction using a PS restored the contact area and peak force to the intact state and improved the contact pressure increases seen after partial labrectomy. The contact area and peak force were normalized, and the labral seal was re-established in most cases. CLINICAL RELEVANCE: This study provides biomechanical evidence for the use of a scaffold for labral reconstruction. |
format | Online Article Text |
id | pubmed-9478710 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-94787102022-09-17 Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration of Femoroacetabular Contact Biomechanics Capurro, Bruno Reina, Francisco Carrera, Anna Monllau, Joan Carles Marqués-López, Fernando Marín-Peña, Oliver Torres-Eguía, Raúl Tey-Pons, Marc Orthop J Sports Med Article BACKGROUND: Many advances have been made in hip labral repair and reconstruction and in the restoration of the suction seal. PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the biomechanical effects of segmental labral reconstruction with a synthetic polyurethane scaffold (PS) in comparison with segmental labrectomy. Our hypothesis was that reconstruction with a icroporous polyurethane implant would normalize joint kinetics of the hip and restore the suction seal. STUDY DESIGN: Controlled laboratory study. METHODS: We used 10 hips from 5 fresh-frozen pelvises with an intact acetabular labrum without osteoarthritis. Using an intra-articular pressure measurement system, the contact area, contact pressure, and peak force were assessed for the following conditions: intact labrum, partial anterosuperior labrectomy, and PS reconstruction. For each condition, all specimens were analyzed in 4 positions (90° of flexion, 90° of flexion and internal rotation, 90° of flexion and external rotation, and 20° of extension) and underwent a labral seal test. The relative change from the intact condition was determined for all conditions and positions. RESULTS: Compared with the intact labrum, labrectomy resulted in a significant decrease in the contact area (P < .001) and a significant increase in the peak force (P < .001) and contact pressure (P < .001) across all positions. Compared with labrectomy, PS reconstruction resulted in a significant increase in the contact area (P < .001) and a significant decrease in the contact pressure (P ≤ .02) and peak force (P < .001) across all positions. Compared with the intact labrum, PS reconstruction restored the contact area and peak force to normal values in all positions (P > .05), whereas the contact pressure was significantly decreased compared with labrectomy (P < .05) but did not return to normal values. The labral seal was lost in all specimens after labrectomy but was restored in 80% of the specimens after PS reconstruction. CONCLUSION: Femoroacetabular contact biomechanics significantly worsened after partial labrectomy; reconstruction using a PS restored the contact area and peak force to the intact state and improved the contact pressure increases seen after partial labrectomy. The contact area and peak force were normalized, and the labral seal was re-established in most cases. CLINICAL RELEVANCE: This study provides biomechanical evidence for the use of a scaffold for labral reconstruction. SAGE Publications 2022-09-14 /pmc/articles/PMC9478710/ /pubmed/36119123 http://dx.doi.org/10.1177/23259671221118831 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Capurro, Bruno Reina, Francisco Carrera, Anna Monllau, Joan Carles Marqués-López, Fernando Marín-Peña, Oliver Torres-Eguía, Raúl Tey-Pons, Marc Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration of Femoroacetabular Contact Biomechanics |
title | Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration
of Femoroacetabular Contact Biomechanics |
title_full | Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration
of Femoroacetabular Contact Biomechanics |
title_fullStr | Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration
of Femoroacetabular Contact Biomechanics |
title_full_unstemmed | Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration
of Femoroacetabular Contact Biomechanics |
title_short | Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration
of Femoroacetabular Contact Biomechanics |
title_sort | hip labral reconstruction with a polyurethane scaffold: restoration
of femoroacetabular contact biomechanics |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478710/ https://www.ncbi.nlm.nih.gov/pubmed/36119123 http://dx.doi.org/10.1177/23259671221118831 |
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