Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan 16;5(1):47-53.
doi: 10.1093/jhps/hnx049. eCollection 2018 Jan.

Labral augmentation with ligamentum capitis femoris: presentation of a new technique and preliminary results

Jan Weidner  1 , Michael Wyatt  1 , Martin Beck  1
Affiliations

Labral augmentation with ligamentum capitis femoris: presentation of a new technique and preliminary results

Jan Weidner et al. J Hip Preserv Surg. .

Abstract

Preservation of an intact labrum and reconstruction of a deficient or worn acetabular labrum are accepted techniques in modern hip surgery. If the remaining labrum is very thin, its intact tip can be preserved and its volume restored with a ligamentum teres graft. Technique and preliminary results of this augmentation technique are presented. Labral augmentation was performed in 16 hips (11 rights) in 16 patients (7 males, mean age 29 years) during surgical dislocation for treatment of femoroacetabular impingement. The acetabular index, lateral center edge angle, asphericity angle and acetabular retroversion index were determined on preoperative X-rays and magnetic resonance imaging. The pre- and postoperative Merle d'Aubigné and Postel score (MdA) was calculated and the Oxford Hip Score (OHS) obtained after 1 year. There were seven Grade 1 and nine Grade 0 hips (Tönnis classification). Mean lateral center edge was 29°. The mean acetabular index was 1.85°. Mean asphericity angle was 62.5°. Mean acetabular retroversion index was 23.4%. Mean MdA improved from 14.5 preoperatively to 17 at 1 year (P < 0.0001). Mean OHS after 1 year was 42. Previous surgery was a risk factor for inferior results: OHS was 44.5 in hips without versus 26 in hips with previous surgery. Mean MdA improved from 15 to 17.5 in patients without previous surgery versus 14 to 16 for the group with previous surgery. Augmentation of the labrum using ligamentum teres shows good clinical results after 1 year. Patients with previous hip surgery had inferior results.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
The degenerated labrum is detached from the acetabulum. Rim trimming is performed if necessary. The labrum is then augmented with the ligamentum teres graft and reattached with bone anchors.
Fig. 2.
Fig. 2.
Intraoperative photograph showing the detached labrum.
Fig. 3.
Fig. 3.
Intraoperative photograph. The ligamentum teres graft is sutured between the labrum and the acetabular rim.
Fig. 4.
Fig. 4.
Intraoperative photograph with the ligamentum teres graft in its final position.
Fig. 5.
Fig. 5.
Intraoperative photograph after reduction of the femoral head.
Fig. 6.
Fig. 6.
Boxplot of the pre- and postoperative Merle d’Aubigné and Postel score.
Fig. 7.
Fig. 7.
Boxplot diagram comparing the pre- and postoperative MdA score for Group 1 (with previous surgery) and Group 2 (no previous surgery).
See this image and copyright information in PMC

References

    1. Bsat S, Frei H, Beaulé PE.. The acetabular labrum. Bone Joint J 2016; 98-B: 730–5. - PubMed
    1. Miozzari HH, Celia M, Clark JM. et al. No regeneration of the human acetabular labrum after excision to bone. Clin Orthop Relat Res 2015; 473: 1349–57. - PMC - PubMed
    1. Espinosa N, Beck M, Rothenfluh DA. et al. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am 2007; 89: 36–53. - PubMed
    1. Haddad B, Konan S, Haddad FS.. Debridement versus re-attachment of acetabular labral tears: a review of the literature and qualitative analysis. Bone Joint J 2014; 96-B: 24–30. - PubMed
    1. Cadet ER, Chan AK, Vorys GC. et al. Investigation of the preservation of the fluid seal effect in the repaired, partially resected, and reconstructed acetabular labrum in a cadaveric hip model. Am J Sports Med 2012; 40: 2218.. - PubMed

LinkOut - more resources