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中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (04) : 456 -461. doi: 10.3877/cma.j.issn.1674-134X.2022.04.011

综述

髋关节镜下治疗盂唇损伤的研究进展
李自愿1, 陈志豪1, 胡刚峰1, 谢宗刚1,()   
  1. 1. 215004 苏州大学附属第二医院骨科
  • 收稿日期:2020-12-25 出版日期:2022-08-01
  • 通信作者: 谢宗刚

Arthroscopic treatment progress of labral tear

Ziyuan Li1, Zhihao Chen1, Gangfeng Hu1, Zonggang Xie1,()   

  1. 1. Department of Orthopedic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
  • Received:2020-12-25 Published:2022-08-01
  • Corresponding author: Zonggang Xie
引用本文:

李自愿, 陈志豪, 胡刚峰, 谢宗刚. 髋关节镜下治疗盂唇损伤的研究进展[J]. 中华关节外科杂志(电子版), 2022, 16(04): 456-461.

Ziyuan Li, Zhihao Chen, Gangfeng Hu, Zonggang Xie. Arthroscopic treatment progress of labral tear[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(04): 456-461.

随着髋关节镜技术在过去十年的快速发展,对盂唇损伤的认识和治疗得到不断更新。治疗盂唇损伤由较早的开放盂唇清理术演变到关节镜下治疗,包括盂唇清理、修复以及近年来开展的盂唇重建术,选择合适的治疗方式是改善短期和中期临床疗效的关键因素。髋臼盂唇损伤是引起髋部疼痛的常见原因,常继发于股骨髋臼撞击综合征、创伤、髋关节发育不良、退变、髋关节过度活动以及关节囊松弛。盂唇损伤的治疗有保守治疗和手术治疗,保守治疗包括:休息、非甾体抗炎药、止痛药、活动改变、物理治疗和关节内注射等。当保守治疗无效时,需要手术治疗,手术治疗包括:盂唇清理术、盂唇修复术和盂唇重建术。髋臼盂唇损伤可以导致髋关节功能障碍,正确诊断盂唇损伤及合适的治疗方式能有效减少关节软骨磨损,预防骨关节炎的发生或延缓发展。

With the rapid development of hip arthroscopy in the past decade, the understanding and treatment of labral tear have been constantly updated. Treatment of labral tear has evolved from the early open labral debridement to arthroscopic treatment, which including labral debridement, repair and labral reconstruction in recent years. Choosing the appropriate treatment method is the main factor to improve the short-term and medium-term clinical efficacy. Acetabular labral tear is a common cause of hip pain, which is often secondary to femoral acetabular impact syndrome, trauma, hip dysplasia, degeneration, hip overactivity and joint capsule relaxation. Treatment of labral tear includes conservative treatment and surgical treatment. Conservative treatment includes rest, non-steroidal anti-inflammatory drugs, analgesics, altered activity, physical therapy and intra-articular injection. When conservative treatment has no effect, surgical treatment is needed, which includes labral debridement, repair and labral reconstruction. Acetabular labrum injury can lead to dysfunction of the hip joint. Correct diagnosis of labrum injury and appropriate treatment can effectively reduce articular cartilage wear and prevent osteoarthritis or delay its progress.

[1]
Andronic O, Nakano N, Daivajna S, et al. Non-arthroplasty iliopsoas impingement in athletes: a narrative literature review[J]. Hip Int, 2019, 29(5): 460-467.
[2]
Domb BG, Hartigan D, Perets I. Decision making for labral treatment in the hip: repair versus débridement versus Reconstruction[J]. J Am Acad Orthop Surg, 2017, 25(3): e53-e62.
[3]
Lodhia P, Gui C, Chandrasekaran S, et al. The economic impact of acetabular labral tears: a cost-effectiveness analysis comparing hip arthroscopic surgery and structured rehabilitation alone in patients without osteoarthritis[J]. Am J Sports Med, 2016, 44(7): 1771-1780.
[4]
Su T, Chen GX, Yang L. Diagnosis and treatment of labral tear[J]. Chin Med J (Engl), 2019, 132(2): 211-219.
[5]
Reiman MP, Goode AP, Cook CE, Hölmich P, Thorborg K. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: a systematic review with meta-analysis[J/OL]. Br J Sports Med201549(12):811.DOI:10.1136/bjsports-2014-094302.
[6]
Anderson LA, Peters CL, Park BB, et al. Acetabular cartilage delamination in femoroacetabular impingement. Risk factors and magnetic resonance imaging diagnosis[J]. J Bone Joint Surg Am, 2009, 91(2): 305-313.
[7]
Harris JD. Hip labral repair: options and outcomes[J]. Curr Rev Musculoskelet Med, 2016, 9(4): 361-367.
[8]
Groh MM, Herrera J. A comprehensive review of hip labral tears[J]. Curr Rev Musculoskelet Med, 2009, 2(2): 105-117.
[9]
De Luigi AJ, Blatz D, Karam C, et al. Use of Platelet-Rich plasma for the treatment of acetabular labral tear of the hip: a pilot study[J]. Am J Phys Med Rehabil, 2019, 98(11): 1010-1017.
[10]
Chen AW, Yuen LC, Ortiz-Declet V, et al. Selective debridement with labral preservation using narrow indications in the hip: minimum 5-Year outcomes with a matched-pair labral repair control group[J]. Am J Sports Med, 2018, 46(2): 297-304.
[11]
Alzaharani A, Bali K, Gudena R, et al. The innervation of the human acetabular labrum and hip joint: an anatomic study[J/OL]. BMC Musculoskelet Disord, 2014, 15: 41. DOI: 10.1186/1471-2474-15-41.
[12]
Woyski D, Mather R3. Surgical treatment of labral tears: debridement, repair, reconstruction[J]. Curr Rev Musculoskelet Med, 2019, 12(3): 291-299.
[13]
Byrd JW, Jones KS. Hip arthroscopy for labral pathology: prospective analysis with 10-year follow-up[J]. Arthroscopy, 2009, 25(4): 365-368.
[14]
Kalhor M, Horowitz K, Beck M, et al. Vascular supply to the acetabular labrum[J]. J Bone Joint Surg Am, 2010, 92(15): 2570-2575.
[15]
Philippon MJ, Arnoczky SP, Torrie A. Arthroscopic repair of the acetabular labrum: a histologic assessment of healing in an ovine model[J]. Arthroscopy, 2007, 23(4):376-380.
[16]
Wu ZX, Ren WX, Ren YM, et al. Arthroscopic labral debridement versus labral repair for patients with femoroacetabular impingement: a meta-analysis[J/OL]. Medicine (Baltimore), 2020, 99(19): e20141. DOI: 10.1097/MD.0000000000020141.
[17]
Suppauksorn S, Beck E C, Chahla J, et al. Comparison of suction seal and contact pressures between 270 degrees labral reconstruction, labral repair, and the intact labrum[J]. Arthroscopy, 2020, 36(9): 2433-2442.
[18]
Frangiamore SJ, Mannava S, Briggs KK, et al. Career length and performance among professional baseball players returning to play after hip arthroscopy[J]. Am J Sports Med, 2018, 46(11): 2588-2593.
[19]
Begly JP, Buckley PS, Utsunomiya H, et al. Femoroacetabular impingement in professional basketball players: return to play, career length, and performance after hip arthroscopy[J]. Am J Sports Med, 2018, 46(13): 3090-3096.
[20]
Lee S, Cvetanovich GL, Mascarenhas R, et al. Ability to return to work without restrictions in workers compensation patients undergoing hip arthroscopy[J]. J Hip Preserv Surg, 2017, 4(1): 30-38.
[21]
Domb BG, Yuen LC, Ortiz-Declet V, et al. Arthroscopic labral base repair in the hip: 5-year minimum clinical outcomes[J]. Am J Sports Med, 2017, 45(12): 2882-2890.
[22]
Perets I, Chaharbakhshi EO, Mu B, et al. Hip arthroscopy in patients ages 50 years or older: minimum 5-year outcomes, survivorship, and risk factors for conversion to total hip replacement[J]. Arthroscopy, 2018, 34(11): 3001-3009.
[23]
Carton PF, Filan D. Labral cuff refixation in the hip: rationale and operative technique for preserving the chondrolabral interface for labral repair: a case series[J]. J Hip Preserv Surg, 2018, 5(1): 78-87.
[24]
Shenoy K, Dai AZ, Sa MR, et al. Arthroscopic repair of hip labrum with suture anchors[J]. Arthrosc Tech, 2017, 6(6): e2143-e2149.
[25]
Sawyer GA, Briggs KK, Gj D, et al. Clinical outcomes after arthroscopic hip labral repair using looped versus pierced suture techniques[J]. Am J Sports Med, 2015, 43(7): 1683-1688.
[26]
Benca E, Dlaska CE, DiFranco MD, et al. Biomechanical comparison of knotless vs. knotted suture anchors in the acetabular rim with respect to bone density[J]. Clin Biomech (Bristol, Avon), 2020, 74: 21-26.
[27]
Suarez-Ahedo C, Martin TJ, Walsh JP, et al. Anatomic labral repair in the hip using a knotless tensionable suture anchor[J]. Arthrosc Tech, 2016, 5(5): e1089-e1094.
[28]
Rhee SM, Kang SY, Jang EC, et al. Clinical outcomes after arthroscopic acetabular labral repair using knot-tying or knotless suture technique[J]. Arch Orthop Trauma Surg, 2016, 136(10): 1411-1416.
[29]
Ross JR, Larson CM, Bedi A. Indications for hip arthroscopy[J]. Sports Health, 2017, 9(5): 402-413.
[30]
Philippon MJ, Briggs KK, Carlisle JC, et al. Joint space predicts THA after hip arthroscopy in patients 50 years and older[J]. Clin Orthop Relat Res, 2013, 471(8): 2492-2496.
[31]
Shi Y, Chen L, Xu Y, et al. Acetabular labral Reconstruction using autografts reduces osteoarthritis development compared with labral resection in a porcine model[J]. Am J Transl Res, 2019, 11(4): 2484-2495.
[32]
White BJ, Herzog MM. Labral reconstruction: when to perform and how[J/OL]. Front Surg, 2015, 2: 27. DOI: 10.3389/fsurg.2015.00027.
[33]
Maldonado DR, Lall AC, Laseter JR, et al. Primary hip arthroscopic surgery with labral reconstruction: is there a difference between an autograft and allograft?[J/OL]. Orthop J Sports Med, 2019, 7(3):2325967119833715. DOI: 10.1177/2325967119833715.
[34]
White BJ, Herzog MM. Arthroscopic labral reconstruction of the hip using iliotibial band allograft and front-to-back fixation technique[J]. Arthrosc Tech, 2016, 5(1): e89-e97.
[35]
Atzmon R, Sharfman ZT, Atoun E, et al. The anatomical properties of the indirect head of the rectus femoris tendon: a cadaveric study with clinical significance for labral reconstruction surgery[J]. Arch Orthop Trauma Surg, 2020, 140(1): 85-92.
[36]
Rathi R, Mazek J. Arthroscopic acetabular labral Reconstruction with rectus femoris tendon autograft: our experiences and early results[J]. J Orthop, 2018, 15(3): 783-786.
[37]
Karns MR, Patel SH, Kolaczko J, et al. Acetabular rim length: an anatomical study to determine reasonable graft sizes for labral Reconstruction[J]. J Hip Preserv Surg, 2017, 4(1): 106-112.
[38]
Ellman MB, Hulse J, Chahla J, et al. Kite measurement technique for enhanced accuracy and technical proficiency of graft preparation in segmental labral reconstruction of the hip[J]. Arthrosc Tech, 2019, 8(9): e1043-e1049.
[39]
Alter T, Beck EC, Mehta N, et al. Reconstruction guide for the measurement of segmental labral insufficiency: an alternative technique for acetabular labral reconstruction[J]. Arthrosc Tech, 2019, 8(3): e223-e229.
[40]
Atzmon R, Radparvar JR, Sharfman ZT, et al. Graft choices for acetabular labral reconstruction[J]. J Hip Preserv Surg, 2018, 5(4): 329-338.
[41]
Byrd J, Jones KS. Arthroscopic acetabular labral repair in patients over the age of 60 years: a matched case-control study[J]. Arthroscopy, 2019, 35(5): 1406-1410.
[42]
Bayley G, Poitras S, Parker G, et al. Hip arthroscopy in patients less than 25 years of age in the treatment of labral tears: aetiology and clinical outcomes[J]. Hip Int, 2017, 27(5): 436-442.
[43]
Philippon MJ, Briggs KK, Hay CJ, et al. Arthroscopic labral Reconstruction in the hip using iliotibial band autograft: technique and early outcomes[J]. Arthroscopy, 2010, 26(6): 750-756.
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