Yoo Jun-Il, Ha Yong-Chan, Hwang Sun-Chul, Oh Jin-Young, Chang Eui-Chan, Lee Young-Kyun, Koo Kyung-Hoi
Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2017 Dec;9(4):405-412. doi: 10.4055/cios.2017.9.4.405. Epub 2017 Nov 10.
The purpose of this study was to evaluate factors associated with the risk of articular surface perforation during anchor placement for arthroscopic acetabular labral repair using follow-up computed tomographic arthrography (CTA).
Forty-six patients (29 males and 17 females) underwent arthroscopic labral repair using 142 suture anchors (55 large anchors and 87 small anchors). The patients were followed with CTA 1 year postoperatively. Anchor position was assessed by the insertion angle and the distance of the suture anchor tip from the articular cartilage. The incidence of malposition of suture anchors was assessed in follow-up CTA. The location and incidence of malposition were compared between two groups divided according to the diameter of suture anchor.
The mean insertion angle and distance were significantly different between the groups. Of the 142 anchors, 15 (11%) were placed in the cartilage-bone transitional zone. Articular involvement was most common at the 3 o'clock position of the suture anchor (six out of 33 anchors, 18.2%). Both the insertion angle and distance showed small values in the articular involvement group.
The radiographic analysis of the placement of suture anchors after arthroscopic labral refixation based on follow-up CTA demonstrates that articular involvement of anchors is related to the location on the acetabular rim (clock position) and anchor diameter.
本研究旨在通过随访计算机断层扫描关节造影(CTA)评估关节镜下髋臼唇修复术锚钉置入过程中关节面穿孔风险的相关因素。
46例患者(29例男性和17例女性)接受了关节镜下唇修复术,共使用142枚缝合锚钉(55枚大锚钉和87枚小锚钉)。术后1年对患者进行CTA随访。通过缝合锚钉的插入角度和锚钉尖端距关节软骨的距离评估锚钉位置。在随访CTA中评估缝合锚钉位置不当的发生率。根据缝合锚钉直径将患者分为两组,比较两组位置不当的部位和发生率。
两组之间的平均插入角度和距离存在显著差异。在142枚锚钉中,15枚(11%)置于软骨-骨过渡区。关节受累在缝合锚钉的3点位置最为常见(33枚锚钉中有6枚,18.2%)。在关节受累组中,插入角度和距离的值均较小。
基于随访CTA对关节镜下唇修复术后缝合锚钉置入情况进行影像学分析表明,锚钉的关节受累与髋臼边缘位置(时钟位置)和锚钉直径有关。