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Defining a safety margin for labral suture anchor insertion using the acetabular rim angle.

Pisit Lertwanich1, Leandro Ejnisman, Michael R Torry

  • 1Steadman Philippon Research Institute, 181 W. Meadow Dr, Suite 1000, Vail, CO 81657, USA.

The American Journal of Sports Medicine
|June 29, 2011
PubMed
Summary

The acetabular rim angle varies by location and drill depth, impacting suture anchor safety. Surgeons must consider these variations, especially at the 3-o'clock position, to avoid cartilage damage.

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Area of Science:

  • Orthopedic surgery
  • Anatomy
  • Biomechanical engineering

Background:

  • Suture anchors are vital for labral reattachment to the acetabular rim.
  • Acetabular rim anatomy is variable, with an unknown safety margin for anchor insertion.
  • The acetabular rim angle quantifies this safety margin.

Purpose of the Study:

  • To analyze acetabular rim angle variations based on clock position.
  • To assess how drill depth influences the acetabular rim angle.
  • To evaluate the impact of acetabular rim trimming on the acetabular rim angle.

Main Methods:

  • 3D acetabular models were created from CT scans of 20 cadaveric hip specimens.
  • Acetabular rim angle was measured at 8- to 4-o'clock positions for varying drill depths (10-25 mm).

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  • Measurements were taken after simulating 2.5-mm and 5-mm rim trimming.

    • Main Results:

    • Acetabular rim angle significantly varied with clock position, drill depth, and rim trimming (P < .0001).
    • The largest angles were at 2-o'clock, smallest at 3-o'clock.
    • Deeper drills reduced the angle; rim trimming increased it.

    Conclusions:

    • Acetabular rim angle is highly location-dependent.
    • Shorter drill depths and greater rim trimming yield larger acetabular rim angles.
    • Awareness of these factors is crucial for safe suture anchor placement, particularly in the anterosuperior quadrant (3-o'clock).