T he acetabular labrum plays an essential role in hip joint stability and function by distributing load and sealing the joint. Recent studies [3, 4, 6, 7] have suggested that acetabular labral tears caused by femoroacetabular impingement (FAI) are a common cause of pain and dysfunction in this patient population, and may contribute to the development of early degenerative hip arthrosis. Both labral excision/debridement and labral preservation/repair techniques have been to help treat FAI. To date, most of the comparative studies have shown better shortand mid-term pain and function outcomes in hip function and pain in patients treated with labral repair when compared with those treated with selective labral debridement [3, 4, 7]. However, in contrast to tears at the chondral-labral junction that are amenable to repair, tears within the labral substance have limited healing capacity secondary to the hypovascularity of this area [2]. In cases where the labrum cannot be repaired, labral reconstruction is an option, especially in younger patients. Labral regrowth after resection has been reported both in animals [5] and humans [1], theoretically obviating the need for a technically challenging labral reconstruction. Abrams et al. [1] reported on 24 patients who underwent a hip arthroscopy 2 years after open hip surgical dislocation with labral debridement for treatment of FAI. All patients demonstrated regrowth of the labrum in the area undergoing previous debridement [1]. The authors found homogeneous regrowth in 21 of 24 patients, with inhomogeneous regrowth noted in three of 24 patients. Labral scarring altering normal labral biomechanical properties and function was noted in four of 24 hips. The presence of scar tissue adversely affects labral function in distributing load and sealing the joint. In the present study, Miozzari and colleagues retrospectively evaluated postoperative MRI hip arthrograms and hip function in nine patients who underwent labral excision to the bony rim for nonreparable lesions. In contrast to Abrams et al. [1], no regrowth of a structure equivalent to normal labrum was noticed 3 to 7 years after segmental resection of the acetabular labrum. More specifically, the authors This CORR Insights is a commentary on the article ‘‘No Regeneration of the Human Acetabular Labrum After Excision to Bone’’ by Miozzari and colleagues available at: DOI: 10.1007/s11999-014-4021-z. The author certifies that he, or any member of his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or the Association of Bone and Joint Surgeons. This CORR Insights comment refers to the article available at DOI: 10.1007/s11999-0144021-z. M. Lykissas MD (&) Department of Orthopaedic Surgery, University of Ioannina School of Medicine, 45110 Ioannina, Greece e-mail: mariolyk@yahoo.com CORR Insights Published online: 25 November 2014 The Association of Bone and Joint Surgeons1 2014
Read full abstract
Sep 15, 2015
Marko Mladenović + 5
Open Access
