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Safe angle for suture anchor insertion during acetabular labral repair.

Jaime D Hernandez¹, Brian E McGrath

¹Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA. jh83@buffalo.edu

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association

|November 29, 2008

Summary

Surgeons can use defined "safe angles" for suture anchor insertion during hip labral repair to ensure anchors are placed in bone and avoid penetrating the hip joint. A 10-degree target angle is recommended for improved fixation and reduced intra-articular risk.

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Area of Science:

Orthopedic surgery
Hip arthroscopy
Anatomy

Background:

Acetabular labral tears are common injuries in athletes.
Suture anchors are frequently used for labral repair.
Accurate anchor placement is crucial to avoid intra-articular complications.

Purpose of the Study:

To determine a safe angle for suture anchor insertion during acetabular labral repair.
To optimize anchor placement within bone and prevent hip joint penetration.

Main Methods:

Anatomical measurements of nine acetabuli were performed.
Suture anchor drills and a protractor were used to measure "safe angles" and "danger angles" at the anterosuperior quadrant.
Statistical analysis (1-way ANOVA, Tukey post-hoc) compared measurements.

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Main Results:

No significant differences in labral insertion point distances or acetabular bone widths.
Mean "danger angles" ranged from 17.0 to 23.8 degrees.
Mean "safe angles" ranged from 20.1 to 27.6 degrees.

Conclusions:

A labral insertion point 2.3-2.6 mm from the anterosuperior acetabular rim is suggested for anchors <3.0 mm.
Defined "danger" and "safe" angles provide intraoperative guidance for anchor placement.
A 10-degree target angle is recommended to ensure bony fixation and minimize intra-articular penetration.