Biomechanical evaluation contribution of the acetabular labrum to hip stability

2015 ◽  
Vol 24 (7) ◽  
pp. 2338-2345 ◽  
Author(s):  
Pisit Lertwanich ◽  
Anton Plakseychuk ◽  
Scott Kramer ◽  
Monica Linde-Rosen ◽  
Akira Maeyama ◽  
...  
2020 ◽  
Vol 48 (11) ◽  
pp. 2726-2732 ◽  
Author(s):  
Hunter W. Storaci ◽  
Hajime Utsunomiya ◽  
Bryson R. Kemler ◽  
Samuel I. Rosenberg ◽  
Grant J. Dornan ◽  
...  

Background: The acetabular labrum has been found to provide a significant contribution to the distractive stability of the hip. However, the influence of labral height on hip suction seal biomechanics is not known. Hypothesis: The smaller height of acetabular labrum is associated with decreased distractive stability. Study Design: Descriptive laboratory study. Methods: A total of 23 fresh-frozen cadaveric hemipelvises were used in this study. Hips with acetabular dysplasia or femoroacetabular impingement–related bony morphologic features, intra-articular pathology, or no measurable suction seal were excluded. Before testing, each specimen’s hip capsule was removed, a pressure sensor was placed intra-articularly, and the hip was fixed in a heated saline bath. Labral size was measured by use of a digital caliper. Maximum distraction force, distance to suction seal rupture, and peak negative pressure were recorded while the hip underwent distraction at a rate of 0.5 mm/s. Correlations between factors were analyzed using the Spearman rho, and differences between groups were detected using Mann-Whitney U test. Results: Of 23 hips, 12 satisfied inclusion criteria. The maximum distraction force and peak negative pressure were significantly correlated ( R = −0.83; P = .001). Labral height was largely correlated with all suction seal parameters (maximum distraction force, R = 0.69, P = .013; distance to suction seal rupture, R = 0.55, P = .063; peak negative pressure, R = −0.62, P = .031). Labral height less than 6 mm was observed in 5 hips, with a mean height of 6.48 mm (SD, 2.65 mm; range, 2.62-11.90 mm; 95% CI, 4.80-8.17 mm). Compared with the 7 hips with larger labra (>6 mm), the hips with smaller labra had significantly shorter distance to suction seal rupture (median, 2.3 vs 7.2 mm; P = .010) and significantly decreased peak negative pressure (median, −59.3 vs −66.9 kPa; P = .048). Conclusion: Smaller height (<6 mm) of the acetabular labrum was significantly associated with decreased distance to suction seal rupture and decreased peak negative pressure. 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. Clinical Relevance: The height of the acetabular labrum is correlated with hip suction seal biomechanics. Further studies are required to identify the clinical effects of labral height on hip stability.


2013 ◽  
Vol 29 (12) ◽  
pp. e205-e206
Author(s):  
Michael Hart ◽  
Geoffrey Abrams ◽  
Christopher Bayne ◽  
Kaosu Takami ◽  
Alejandro Espinoza-Orias ◽  
...  

2011 ◽  
Vol 39 (1_suppl) ◽  
pp. 85-91 ◽  
Author(s):  
Casey A. Myers ◽  
Bradley C. Register ◽  
Pisit Lertwanich ◽  
Leandro Ejnisman ◽  
W. Wes Pennington ◽  
...  

2011 ◽  
Vol 27 (10) ◽  
pp. e96-e97 ◽  
Author(s):  
Marc J. Philippon ◽  
Casey A. Myers ◽  
W. Wesley Pennington ◽  
Pisit Lertwanich ◽  
Leandro Ejnisman ◽  
...  

2011 ◽  
Vol 39 (1_suppl) ◽  
pp. 103-110 ◽  
Author(s):  
Matthew V. Smith ◽  
Hemang B. Panchal ◽  
Ramon A. Ruberte Thiele ◽  
Jon K. Sekiya

2006 ◽  
Vol 11 (6) ◽  
pp. 4-7
Author(s):  
Charles N. Brooks ◽  
Richard E. Strain ◽  
James B. Talmage

Abstract The primary function of the acetabular labrum, like that of the glenoid, is to deepen the socket and improve joint stability. Tears of the acetabular labrum are common in older adults but occur in all age groups and with equal frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all rely on production of pain in the groin (typically), clicking, and/or locking with passive or active hip motions. Diagnostic tests or procedures rely on x-rays, conventional arthrography, computerized tomography, magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and hip arthroscopy. Hip arthroscopy is the gold standard for diagnosis but is the most invasive and most likely to result in complications, and MRA is about three times more sensitive and accurate in detecting acetabular labral tears than MRI alone. Surgical treatment for acetabular labrum tears usually consists of arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of-motion tests).


Author(s):  
Jianfeng Kang ◽  
Enchun Dong ◽  
Xiangdong Li ◽  
Zheng Guo ◽  
Lei Shi ◽  
...  

2021 ◽  
Vol 6 ◽  
pp. 247275122110192
Author(s):  
Karel Kuik ◽  
Jean Pierre T. F. Ho ◽  
Cornelis Klop ◽  
Maurits H. T. de Ruiter ◽  
Cornelis J. Kleverlaan ◽  
...  

Study Design: Biomechanical in vitro study. Mandibular advancement after sagittal split ramus osteotomy (SSRO) is a common procedure in orthognathic surgery. Several fixation methods are used for stabilization of SSRO. Objective: The aim of this study was to compare a new fixation method (gridplate) with more contemporary applied methods of fixation. Material and Methods: In this study, 50 polyurethane hemimandibles with a prefabricated SSRO were used as specimens. All hemimandibles were advanced by 8 mm and divided into 5 groups with different fixation methods: (A) one 4-hole miniplate with 4 monocortical screws; (B) two 4-hole miniplates with 8 monocortical screws; (C) one 4-hole miniplate with 4 monocortical screws and 1 bicortical screw in the retromolar area (hybrid method); (D) 3 bicortical screws in an inverted-L pattern; and (E) one 8-hole gridplate with 8 monocortical screws. Loads in newtons were recorded at displacements of the mandibular incisive edge at 1 mm, 3 mm and 5 mm. Results: Fixation with 3 bicortical screws and the gridplate presented the most stability, followed by two 4-hole miniplates. Fixation with the hybrid method or the single miniplate showed the least stability. Conclusion: According to the results of this study, the 8-hole gridplate design appears a sufficient fixation method regarding stabilization of SSRO with larger mandibular advancement.


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