Our Summary

This research paper is about a specific tool used in a type of keyhole surgery to repair the labrum, a ring of cartilage found in the hip joint. This tool, known as a knotless anchor, helps to hold stitches in place during the operation. The paper investigates the ways these anchors can fail, which are either the stitches breaking or pulling out from the anchor. The study finds that these knotless anchors are generally stable and effective under normal body stress. However, surgeons should consider the size of the tool used to pass the stitches and aim to use one that makes the smallest hole in the labrum to minimize damage.

FAQs

  1. What role do knotless anchors play in arthroscopic acetabular labral repair?
  2. What are the two primary failure modes of different anchors?
  3. Why is the size of the suture-passing device important in labral repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about labral repair is to follow post-operative rehabilitation protocols closely to optimize healing and prevent re-injury. This may include physical therapy exercises to strengthen the surrounding muscles and improve range of motion, as well as avoiding certain activities that could put stress on the repaired labrum. It is important to communicate any pain or discomfort during the recovery process to your doctor to ensure proper healing.

Suitable For

Patients who are typically recommended labral repair are those who have experienced a labral tear in the hip joint, often due to trauma, repetitive motion, or underlying hip conditions such as hip impingement. Labral tears can cause pain, stiffness, and instability in the hip joint, leading to difficulty with daily activities and sports participation. Labral repair is often recommended for patients who have failed conservative treatments such as physical therapy and medication, and who have persistent symptoms that significantly impact their quality of life. Additionally, patients who are young and active, and who have a good chance of successful outcomes with surgery, may also be recommended for labral repair.

Timeline

Before labral repair:

  1. Patient experiences hip pain, clicking, or locking, especially during physical activity.
  2. Patient undergoes a physical examination, imaging tests (such as MRI or CT scan), and possibly a diagnostic hip arthroscopy to confirm the labral tear diagnosis.

After labral repair:

  1. Patient undergoes arthroscopic acetabular labral repair using knotless anchors.
  2. Surgeon uses suture-passing device to secure the labrum to the acetabulum without tying knots.
  3. Patient undergoes post-operative rehabilitation, including physical therapy to strengthen the hip muscles and improve range of motion.
  4. Patient gradually resumes normal activities and sports as recommended by the surgeon.

What to Ask Your Doctor

  1. What is the success rate of labral repair using knotless anchors?
  2. What are the potential risks and complications associated with this procedure?
  3. How long is the recovery process following labral repair?
  4. Will physical therapy be necessary after the surgery, and if so, for how long?
  5. Are there any restrictions or limitations on activities following labral repair?
  6. How soon can I expect to return to normal daily activities and exercise?
  7. What is the long-term outlook for the repaired labrum?
  8. Are there any alternative treatment options to consider?
  9. How many of these procedures have you performed, and what is your experience with this technique?
  10. What steps can I take to ensure a successful outcome of the labral repair surgery?

Reference

Authors: Barber FA, Lee Evanson JR. Journal: Arthroscopy. 2019 Jan;35(1):77-79. doi: 10.1016/j.arthro.2018.09.003. PMID: 30611369