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Review
. 2018 Sep 27;5(4):329-338.
doi: 10.1093/jhps/hny033. eCollection 2018 Dec.

Graft choices for acetabular labral reconstruction

Ran Atzmon  1 , Joshua R Radparvar  2 , Zachary T Sharfman  3 , Alison A Dallich  2 , Eyal Amar  2 , Ehud Rath  2
Affiliations
Review

Graft choices for acetabular labral reconstruction

Ran Atzmon et al. J Hip Preserv Surg. .

Abstract

The acetabular labrum plays a key role in maintaining hip function and minimizing hip degeneration. Once thought to be a rare pathology, advances in imaging have led to an increase in the number of diagnosed labral tears. While still a relatively new field, labral reconstruction surgery is an option for tears that are irreparable or require revision after primary repair. Various autograft and allograft options exist when considering labral reconstruction. The first labral reconstruction surgery was described using the ligamentum teres capitis, and has since evolved, incorporating more graft sources and reconstructive techniques. The purpose of this review is to assess and describe the different graft sources and technique currently implemented by hip surgeons. Moreover, this review attempts to determine whether a single labral reconstructive graft type is superior to the others. Techniques using the Ligamentum teres capitis autograft, ITB autograft, gracilis autograft, quadriceps tendon autograft, capsular autograft, semitendinosus allograft, indirect head of the rectus femoris autograft, peroneus brevis tendon allograft and Tensor fascia lata allograft were found. Scoring was available on 5 out of the 9 graft types. The advantages and disadvantages of each graft source is described as a comparative tool. No single graft type has shown increased benefit in acetabular labral reconstruction. The lack of uniform outcome measurements hinders comparison of reported outcomes. Surgeons should make an informed decision based on their experience as well as the patient's history and needs when choosing which graft type would be best suited for their patients.

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Figures

Fig. 1.
Fig. 1.
A cadaveric dislocated left hip after dissection with the capsule removed shows the acetabular socket [A], labrum [solid line L], direct head of the rectus femoris tendon [R] and the indirect head of the rectus femoris tendon [I].
Fig. 2.
Fig. 2.
(A) An axial MR arthrogram and (B) a coronal MR arthrogram show labral tear with contrast material extending beyond the joint space. A red asterisk depicts a folded labrum surrounded by contrast material in both images.
Fig. 3.
Fig. 3.
Shows the direct measurement of a labral defect using a special arthroscopic measuring tool.
Fig. 4.
Fig. 4.
(A) Depicts harvesting of the tensor fascia lata graft and (B) depicts the prepared and tubularized tensor fascia lata.
See this image and copyright information in PMC

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