Herickhoff Paul K, Widner Matthew, Mascoe Jason, Sebastianelli Wayne J
Penn State Sports Medicine, State College, Pennsylvania, U.S.A.
Penn State Orthopaedics and Rehabilitation, Hershey, Pennsylvania, U.S.A.
Arthrosc Sports Med Rehabil. 2021 Aug 19;3(5):e1505-e1511. doi: 10.1016/j.asmr.2021.07.012. eCollection 2021 Oct.
To determine the accuracy of fluoroscopy-guided suture anchor placement for arthroscopic acetabular labral repair in cadaveric hip specimens.
Two sports medicine fellowship-trained surgeons performed arthroscopic hip surgery on 6 cadaveric specimens each. Suture anchors were placed at the 11-, 12-, 1-, 2-, 3-, and 4-o'clock positions of the acetabulum in each specimen using a previously described fluoroscopically guided technique. Gross dissection and thin-cut computed tomography scans were performed to assess for accuracy. The insertion angle between the subchondral bone and the drill bit immediately prior to suture anchor insertion was measured, and fluoroscopic visualization of the subchondral bone at each clock-face position was qualitatively graded as good, fair, or poor by 2 independent reviewers.
Overall, 90.3% of attempts (65 of 72) were entirely intraosseous, 5.5% (4 of 72) perforated the articular cartilage, and 4.2% (3 of 72) perforated the far cortex, rates that are comparable with those in previous cadaveric studies. There was no statistically significant difference in accuracy between the surgeons ( = .42) or between the various clock-face positions ( = .63). Neither the insertion angle ( = .26) nor visualization of the subchondral bone ( = .35) was significantly correlated with accuracy by gross dissection.
In a cadaveric hip arthroscopy model, fluoroscopy-guided suture anchor placement yields excellent accuracy rates, similar to non-image-guided techniques.
Intra-articular suture anchor placement and intrapelvic suture anchor placement are known complications of arthroscopic acetabular labral repair. Fluoroscopically guided suture anchor placement can be a useful tool for hip arthroscopy surgeons performing acetabular labral repair and reconstruction, potentially reducing the risk of these complications.
确定在尸体髋关节标本中，在荧光透视引导下进行关节镜下髋臼盂唇修复时缝合锚钉置入的准确性。
两名接受过运动医学专科培训的外科医生分别对6个尸体标本进行关节镜髋关节手术。使用先前描述的荧光透视引导技术，在每个标本的髋臼11点、12点、1点、2点、3点和4点位置置入缝合锚钉。进行大体解剖和薄层计算机断层扫描以评估准确性。测量在即将置入缝合锚钉之前软骨下骨与钻头之间的插入角度，并且由2名独立的评估者将每个钟面位置的软骨下骨的荧光透视可视化定性地分级为良好、中等或差。
总体而言，90.3%（72次尝试中的65次）的置入完全在骨内，5.5%（72次中的4次）穿透关节软骨，4.2%（72次中的3次）穿透对侧皮质，这些发生率与先前尸体研究中的发生率相当。外科医生之间（P = 0.42）或各个钟面位置之间（P = 0.63）在准确性方面没有统计学上的显著差异。无论是插入角度（P = 0.26）还是软骨下骨的可视化（P = 0.35）与大体解剖的准确性均无显著相关性。
在尸体髋关节镜模型中，荧光透视引导下的缝合锚钉置入产生了优异的准确率，类似于非影像引导技术。
关节内缝合锚钉置入和盆腔内缝合锚钉置入是关节镜下髋臼盂唇修复已知的并发症。荧光透视引导下的缝合锚钉置入对于进行髋臼盂唇修复和重建的髋关节镜外科医生可能是一种有用的工具，有可能降低这些并发症的风险。
