Johns William L, Baumann Anthony N, Callaghan Megan E, Walley Kempland C, Patel Neel K, Salvo John
Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA.
Am J Sports Med. 2025 Feb;53(2):480-492. doi: 10.1177/03635465241239689. Epub 2025 Jan 11.
Arthroscopic labral repair of the hip is successfully performed with increasing frequency using either knotless or knotted suture anchors, each with its own risks and benefits.
To examine biomechanical and clinical outcomes for labral repair of the hip based on the use of knotted or knotless suture anchors.
Systematic review; Level of evidence, 4.
A search was performed to retrieve clinical and biomechanical studies examining the use of knotless or knotted suture anchors for arthroscopic labral repair of the hip. The studied outcomes included functional outcome scores such as modified Harris Hip Score (mHHS) and Hip Outcome Score Activities of Daily Living, biomechanical outcomes, failure mechanisms, and complications such as revision/reoperation and conversion to total hip arthroplasty (THA).
A total of 47 articles met inclusion criteria for analysis (5 articles examining biomechanical outcomes and 42 reporting clinical outcomes). Included patients (N = 6185) who underwent hip labral repair had a mean age of 33.0 ± 8.5 years and follow-up time of 43.8 ± 18.4 months. The knotless group (n = 2719) had a mean preoperative mHHS of 63.3 ± 4.1 and postoperative mHHS of 86.3 ± 2.8 at a mean follow-up time of 47.2 ± 16.1 months. The knotted group (n = 2600) had a mean preoperative mHHS of 69.5 ± 8.3 and postoperative mHHS of 88.8 ± 5.5 with a mean follow-up time of 44.8 ± 18.1 months. The most common reason for failure of knotless anchors in biomechanical studies was suture breakage or pullout, and for knotted anchors it was anchor pullout. Of the articles reporting on revisions and/or conversion to THA after labral repair, the knotless group had 225 reoperations (8.1%) and 123 cases of conversion to THA (4.4%). The knotted group had 101 reoperations (6.2%) and 31 cases of conversion to THA (1.9%).
Arthroscopic management of labral repairs of the hip using either knotless or knotted suture anchors appears to be both safe and effective in reducing pain and improving function. Biomechanical evaluation suggests differing failure mechanisms in knotted versus knotless anchors. The rates of revision and conversion to THA are low overall, irrespective of knotted or knotless anchors.
使用无结或有结缝合锚钉进行髋关节镜下盂唇修复的频率越来越高，且都有各自的风险和益处。
基于有结或无结缝合锚钉的使用情况，研究髋关节盂唇修复的生物力学和临床结果。
系统评价；证据等级，4级。
进行检索以获取关于使用无结或有结缝合锚钉进行髋关节镜下盂唇修复的临床和生物力学研究。研究结果包括功能结果评分，如改良Harris髋关节评分（mHHS）和髋关节日常生活活动结果评分、生物力学结果、失败机制以及并发症，如翻修/再次手术和转为全髋关节置换术（THA）。
共有47篇文章符合纳入分析的标准（5篇研究生物力学结果，42篇报告临床结果）。纳入的接受髋关节盂唇修复的患者（N = 6185）平均年龄为33.0±8.5岁，随访时间为43.8±18.4个月。无结组（n = 2719）术前平均mHHS为63.3±4.1，在平均随访时间47.2±16.1个月时术后mHHS为86.3±2.8。有结组（n = 2600）术前平均mHHS为69.5±8.3，术后mHHS为88.8±5.5，平均随访时间为44.8±18.1个月。生物力学研究中无结锚钉失败的最常见原因是缝线断裂或拔出，有结锚钉则是锚钉拔出。在报告盂唇修复后翻修和/或转为THA的文章中，无结组有225例再次手术（8.1%）和123例转为THA（4.4%）。有结组有101例再次手术（6.2%）和31例转为THA（1.9%）。
使用无结或有结缝合锚钉进行髋关节盂唇修复的关节镜治疗在减轻疼痛和改善功能方面似乎既安全又有效。生物力学评估表明有结与无结锚钉的失败机制不同。总体而言，无论使用有结还是无结锚钉，翻修和转为THA的发生率都较低。
