Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleArthroscopic Repair of the Acetabular Labrum: A Histologic Assessment of Healing in an Ovine Model
Section snippets
Methods
After institutional animal care and use committee approval was obtained, the left hip joint of 10 adult female sheep was accessed via arthroscopy under general anesthesia and by use of sterile surgical technique. The animals were positioned on the right side in a semisupine position, and the left rear limb was distracted in a caudal direction with approximately 15° of abduction against a padded post. Arthroscopic access to the hip joint was made under fluoroscopic control by use of two portals:
Results
As in human beings, the results of this study show that the acetabular labrum of the sheep is a fibrocartilaginous extension of the acetabulum.[21, 22 It varies in width as it courses anterior (cranial) to posterior (caudal) along the peripheral rim of the acetabulum. It is a fibrocartilaginous structure similar in histologic structure to that of human beings and is intimately attached to the acetabulum (Fig 1). Like the human acetabular labrum, that of the sheep has a poor vascular supply,
Discussion
The contribution of the acetabular labrum to normal biomechanical function of the hip joint is well known.[10, 14, 15, 16, 17 Although a previous animal study has suggested that a partially resected acetabular labrum can spontaneously regenerate,[25 the ability of a resected human acetabular labrum to regenerate functional and biomechanically competent replacement tissue has not been proved. A recent study has suggested that at 2 years, patients who have undergone labral repair had results that
Conclusions
The results of this study support the concept that surgically created acetabular-labral lesions in sheep that are repaired via a minimally invasive arthroscopic technique are capable of partial healing by 12 weeks. Depending on the location of the lesion, the labrum appears to heal by way of fibrovascular repair tissue that originates from the capsular tissues (for intra-labral lesions) or reattachment by direct new bone formation (for labral lesions that are repaired to exposed acetabular
Acknowledgment
The authors thank Simon Turner, D.V.M., and Troy Trumble, D.V.M., Ph.D., from Colorado State University, Fort Collins, Colorado, and Brian T. Kelly, M.D., from the Hospital for Special Surgery, New York, New York, for their contributions to this study.
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Supported by Smith & Nephew Endoscopy. Research performed at Colorado State University, Fort Collins, Colorado, and Michigan State University, East Lansing, Michigan. Drs. Philippon and Arnoczky are paid consultants for Smith & Nephew Endoscopy, and Mr. Torrie is an employee of Smith & Nephew Endoscopy.