The hip fluid seal—Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction

  title={The hip fluid seal—Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction},
  author={Jeffrey J. Nepple and Marc J. Philippon and Kevin J. Campbell and Grant J. Dornan and Kyle S. Jansson and Robert F. LaPrade and Coen A. Wijdicks},
  journal={Knee Surgery, Sports Traumatology, Arthroscopy},
PurposeThe acetabular labrum is theorized to be important to normal hip function by providing stability to distraction forces through the suction effect of the hip fluid seal. The purpose of this study was to determine the relative contributions of the hip capsule and labrum to the distractive stability of the hip, and to characterize hip stability to distraction forces in six labral conditions: intact labrum, labral tear, labral repair (looped vs. through sutures), partial resection, labral… 

The Hip Suction Seal, Part I: The Role of Acetabular Labral Height on Hip Distractive Stability

Smaller height of the acetabular labrum was significantly associated with decreased distance to suction seal rupture and decreased peak negative pressure, and a new strategy to increase the size of the labrum, such as labral augmentation, could be justified for patients with smaller labra in order to optimize the hip suction Seal.

The Hip Suction Seal, Part II: The Effect of Rim Trimming, Chondrolabral Junction Separation, and Labral Repair/Refixation on Hip Distractive Stability

The labral refixation reduced labral mobility, which could be beneficial for both pain relief and labral healing to the acetabulum after pincer-type femoroacetabular impingement resection.

Effects of Capsular Reconstruction With an Iliotibial Band Allograft on Distractive Stability of the Hip Joint: A Biomechanical Study

Capsular reconstruction with an ITB allograft significantly increased the force required to distract the hip compared with a capsular defect in a cadaveric model and should be considered an effective treatment option for patients with symptomatic capsular deficiency.

Vertical Extension of the T-Capsulotomy Incision in Hip Arthroscopic Surgery Does Not Affect the Force Required for Hip Distraction: Effect of Capsulotomy Size, Type, and Subsequent Repair

The conversion of interportal capsulotomy to T-capsulotomy did not significantly affect the force required to distract the hip in a cadaveric model and complete capsular repair demonstrated the ability to restore joint stability to the native, intact hip.

Evaluation of Repair of the Hip Labrum under Simulated Full Weight-Bearing

  • J. KohKavish Gupta
  • Medicine
    Hip international : the journal of clinical and experimental research on hip pathology and therapy
  • 2017
Acetabular labral suture anchor repairs may be able to immediately withstand the physiological loads of axial weight-bearing immediately after repair, preserving the strength and integrity of muscles and soft tissues.

Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration of Femoroacetabular Contact Biomechanics

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, providing biomechanical evidence for the use of a scaffold for labral reconstruction.

Biomechanical evaluation contribution of the acetabular labrum to hip stability

The acetabular labrum provides stability to the hip joint in response to a distraction force and combined distraction and translation forces and could be crucial for restoration of the hip biomechanics and prevention of coxarthrosis.

Evaluation of the sealing function of the acetabular labrum: an in vitro biomechanical study

It is suggested that labral repair is important in the function of the hip and that the vertical mattress suture technique may be better than the cerclage suture repair.

Design of Hip Simulation Machine for Hip Labrum Testing

The purpose of this study was to study pressurization in three labral conditions including intact labrum, labral repair and labral reconstruction and helped the surgeon to make a decision in surgery process.



Effect of Acetabular Labrum Tears on Hip Stability and Labral Strain in a Joint Compression Model

The findings suggest that the acetabular labrum continues to function to resist femoral head translation despite chondral-labral separation and that labral preservation, particularly with larger tears, may be important for maintaining hip stability.

THE 2007 FRANK STINCHFIELD AWARD: The Biomechanics of the Hip Labrum and the Stability of the Hip

A breach of the integrity of labral function is shown to lead to decreased femoral stability relative to the acetabulum during extreme ranges of motion.

Arthroscopic labral reconstruction in the hip using iliotibial band autograft: technique and early outcomes.

Results of Arthroscopic Labral Reconstruction of the Hip in Elite Athletes

Arthroscopic labral reconstruction using an ipsilateral iliotibial band autograft provides good short-term clinical outcomes, high patient satisfaction, and a satisfactory level of return to play in a select group of elite athletes.

An in vitro investigation of the acetabular labral seal in hip joint mechanics.

Effects of traction, distension, and joint position on distraction of the hip joint: an experimental study in cadavers.

  • M. DienstR. Seil D. Kohn
  • Medicine
    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
  • 2002
High traction forces by breakage of the joint seal can be avoided by distension using air, and reducing the amount of traction may possibly reduce the risk of soft tissue perineal and neurologic injuries.

Acetabular Labral Reconstruction With an Iliotibial Band Autograft

The midterm results of this technique with a follow-up from 3 to 6 years after reconstruction showed excellent patient-reported outcomes and high patient satisfaction with outcome, and joint space of ≤2 mm was found to be a poor prognostic factor for survival of the hip.

Traction versus distension for distraction of the joint during hip arthroscopy.

  • J. W. ByrdK. Chern
  • Medicine
    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
  • 1997

Intracapsular and atmospheric pressure in the dynamics and stability of the hip. A biomechanical study.

It is proposed that intracapsular fluid makes the joint potentially unstable, a prerequisite for unfavorable mechanical cartilage load, and have clinical implications in synovitis, septic and juvenile arthritis, congenital dislocation of the hip, arthroplasty, and trauma.

In Vivo Comparison of Hip Separation After Metal-on-Metal or Metal-on-Polyethylene Total Hip Arthroplasty

Femoral head sliding commonly occurred following traditional metal-on-polyethylene total hip arthroplasty but not after metal- on-metal arthroPLasty, and kinematic data may be of value in future hip-simulation studies to better duplicate wear patterns observed in retrieval analyses.