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新鲜半月板同种异体移植关节镜下髋关节盂唇重建术

Arthroscopic Hip Labral Reconstruction With Fresh Meniscal Allograft.

作者信息

Beyer Julia J, Richards Jarod A, Woodard David R, Cook James L, Crist Brett D, DeFroda Steven F

机构信息

Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A.

Department of Orthopaedic Surgery, Sports Medicine Institute, University of Louisville, Louisville, Kentucky, U.S.A.

出版信息

Arthrosc Tech. 2025 Feb 6;14(5):103459. doi: 10.1016/j.eats.2025.103459. eCollection 2025 May.

Abstract

The acetabular labrum functions to protect the overall health of the hip joint through maintenance of joint biomechanics and the fluid suction seal, which decreases stress and strain on the cartilage. Labral reconstruction has emerged as a promising treatment option for the management of irreparable labral pathology. Meniscal allograft has been considered an option for labral reconstruction due to its structural and functional similarities to the native labrum. We present an arthroscopic technique for labral reconstruction using fresh meniscal allograft. A nonviable residual labrum in the setting of pain is the primary indication for this treatment. The open application of this meniscal transplantation technique has resulted in a higher initial success rate, superior patient-reported outcomes, and subjectively better magnetic resonance imaging tissue incorporation than tibialis anterior transplantation controls. The native hip labrum is more similar to meniscal tissue than tendon tissue at biomechanical and cellular levels. Meniscal tissue is naturally load-sharing, which makes it a better tissue for hip labral reconstruction. Cellular, biomechanical, and outcome analyses are underway to further investigate this technique.

摘要

髋臼唇通过维持关节生物力学和液体抽吸密封来保护髋关节的整体健康,从而减少软骨上的应力和应变。唇重建已成为治疗不可修复唇病变的一种有前景的治疗选择。由于半月板同种异体移植物与天然髋臼唇在结构和功能上相似,因此已被视为唇重建的一种选择。我们提出了一种使用新鲜半月板同种异体移植物进行唇重建的关节镜技术。疼痛情况下不可存活的残余髋臼唇是该治疗的主要指征。与胫骨前移植对照组相比,这种半月板移植技术的开放应用导致了更高的初始成功率、更好的患者报告结局以及主观上更好的磁共振成像组织融合。在生物力学和细胞水平上,天然髋关节唇与半月板组织比与肌腱组织更相似。半月板组织具有自然的负荷分担能力,这使其成为髋关节唇重建的更好组织。正在进行细胞、生物力学和结果分析以进一步研究该技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/418c/12177459/134832dc32be/gr1.jpg

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