Maldonado David R, Lall Ajay C, Walker-Santiago Rafael, Rosinsky Philip, Shapira Jacob, Chen Jeffrey W, Domb Benjamin G
American Hip Institute, 999 E Touhy Ave, Des Plaines, IL, USA.
J Hip Preserv Surg. 2019 Mar 1;6(1):41-49. doi: 10.1093/jhps/hnz008. eCollection 2019 Jan.
To survey high-volume hip arthroscopists regarding their current indications for labral reconstruction, graft preference and technique. In May 2018, a cross-sectional based survey was conducted on high-volume hip arthroscopists. A high-volume surgeon was defined as an orthopaedist who had case experience ranging from 50 to 5000 hip arthroscopies performed annually. The survey included their current indications for labral reconstruction, graft preference and technique. Twelve high-volume surgeons successfully completed the questionnaire. The mean arthroscopic procedures performed by the surgeons annually was 188.7 (range 60-350). Four surgeons (33.3%) performed <5 labral reconstruction cases per year, three (25.0%) 5-10 cases per year, two (16.7%) 11-15 cases per year and three (25.0%) over 20 cases per year. Of the 12 surgeons, 11 (91.6%) would reconstruct in certain primary settings and 100% would reconstruct in revision settings. In the primary setting, the main indications for reconstruction were poor quality labral tissue, calcified labrum and hypoplastic labrum. None of the surgeons recommended labral reconstruction for reparable labral tears in primary cases. In primary cases of irreparable labra, 58.3% of the surgeons favoured reconstruction over debridement. In revisions, 100% of the surgeon favoured reconstruction over debridement; 91.7% chose an allograft option versus an autograft alternative. Amongst high-volume arthroscopists, labral reconstruction was considered a valuable technique to restore labral function. Labral reconstruction was more often advocated in revision than in primary settings. Allograft was the preferred choice for reconstruction. Excision of the labral tissue prior to reconstruction was favoured over augmentation. Fewer surgeons performed circumferential reconstruction than segmental reconstruction.
就目前盂唇重建的适应症、移植物偏好及技术，对大量开展髋关节镜手术的医生进行调查。2018年5月，对大量开展髋关节镜手术的医生进行了一项横断面调查。大量开展手术的外科医生定义为每年有50至5000例髋关节镜手术病例经验的骨科医生。该调查包括他们目前盂唇重建的适应症、移植物偏好及技术。12位大量开展手术的外科医生成功完成了问卷。这些外科医生每年平均进行的关节镜手术为188.7例（范围60 - 350例）。4位外科医生（33.3%）每年进行少于5例盂唇重建手术，3位（25.0%）每年进行5 - 10例，2位（16.7%）每年进行11 - 15例，3位（25.0%）每年进行超过20例。在这12位外科医生中，11位（91.6%）会在某些初次手术情况下进行重建，100%会在翻修手术中进行重建。在初次手术情况下，重建的主要适应症是盂唇组织质量差、盂唇钙化和盂唇发育不全。没有外科医生推荐在初次病例中对可修复的盂唇撕裂进行盂唇重建。在初次不可修复盂唇的病例中，58.3%的外科医生倾向于重建而非清创。在翻修手术中，100%的外科医生倾向于重建而非清创；91.7%选择同种异体移植物而非自体移植物。在大量开展髋关节镜手术的医生中，盂唇重建被认为是恢复盂唇功能的一项有价值的技术。与初次手术情况相比，翻修手术中更常提倡进行盂唇重建。同种异体移植物是重建的首选。重建前切除盂唇组织比增强盂唇更受青睐。进行圆周重建的外科医生比节段性重建的更少。
