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Arthroscopic labral reconstruction using fascia lata allograft: shuttle technique and minimum two-year results
Dominic S Carreira1, Matthew C Kruchten2, Brendan R Emmons1
1Peachtree Orthopedics, 3200 Downwood Circle NW Suite 700, Atlanta, GA, USA.
Abstract:
The purpose of this study was to describe the shuttle technique of acetabular labral reconstruction using allograft fascia lata and report minimum two-year clinical outcomes in a prospective patient cohort. We present a shuttle technique to introduce and fixate the allograft, by which the need to fix the free end of the graft from inside the joint is avoided. Between October 2010 and March 2014, 693 hip arthroscopic surgeries were performed by the senior author. Of these 693 patients, 34 patients underwent a labral reconstruction procedure using allograft fascia lata and the shuttle technique and met inclusion criteria. Outcome measures were collected at minimum two years postoperatively. 91.2% (31) of reconstruction patients were available for follow-up at minimum two years after surgery with 12.9% (4) of these patients converting to total hip arthroplasty at average time 27.9 months post-surgery. For the remaining reconstruction patients, mean mHHS increased from 64.0 preoperatively to 84.6 postoperatively (P = 0.0015), SF-12 Physical from 38.9 to 49.0 (P = 0.0004), SF-12 Mental from 49.5 to 55.6 (P = 0.0095), iHOT-12 from 36.4 to 68.1 (P = 0.0017), HOS-ADL from 62.6 to 81.6 (P = 0.0032) and HOS-SS from 32.9 to 65.7 (P < 0.0001). Arthroscopic acetabular labral reconstruction using fascia lata allograft and a shuttle technique appears to be an effective procedure for the treatment of labral pathology through minimum two-year follow-up. While it is difficult to discern the direct influence of the labral reconstructive procedure given the treatment of often concomitant intra-articular pathology, this patient cohort has fared similarly to other cohorts of labral reconstruction patients. No major adverse events are reported.
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