Simultaneous Acetabular Labrum Reconstruction and Remplissage of the Femoral Head–Neck Junction

Figures

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  Fig 1. Right hip. Dunn radiographic image of a patient that had undergone cam over-resection (white arrow) with loss of the hip suction seal. (FH, femoral head).

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  Fig 2. Right hip. Scope in the anterolateral portal. Arthroscopic view of the defect showing excessive resection of the femoral head-neck junction with loss of the normal femoral head-neck contour. Area of excessive resection are noted with black arrow. (C, capsule; FH, femoral head).

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  Fig 3. Right hip. Labral reconstruction with a semitendinosus autograft. Two Iconix 1.4-mm (Stryker) suture anchors preloaded with a No. 2 FiberWire, medial and lateral, were placed in the acetabular rim (A). The extent of the labral deficiency is measure to estimate the graft appropriate length using the Superior Capsule Reconstruction Guide (Arthrex) (white arrow) (B). A semitendinous graft is harvested from the ipsilateral knee and prepared (C and D). Using a shuttle technique, the graft is delivered into the joint and fixed (E and F). (F, femoral head; AC, acetabulum).

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  Fig 4. Right hip. From the anteromedial portal (black arrow) a 2.4-mm Iconix (Stryker) suture anchor preloaded with a No. 2 FiberWire is placed in the medial extension of the defect and the sutures brought out the cannula.

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  Fig 5. Arthroscopic image of a right hip as viewed through the anterolateral portal. A 2.4-mm Iconix suture anchor preloaded with a No. 2 FiberWire is placed (black arrow) in the medial extension of the defect (A and B) Another similar anchor is placed in the center of the defect (C). (black arrow) (LG, labral graft).

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  Fig 6. Intraoperative photograph of a right hip with 2 arthroscopic cannula placed in the midanterior portal and in the distal anterolateral portal. The arthroscope is positioned in the anterolateral portal. Sutures from the anchor placed in the center of the defect are brought through and passed through the middle of the dermal graft (black arrow) (A and B).

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  Fig 7. Arthroscopic image of a right hip as viewed through the anterolateral portal. Then, the graft is delivered into the joint, positioned on the defect, and fixed with arthroscopic knots (A). A suture limb of the most medial anchor is passed in a piercing fashion using a Scorpion (Arthrex) suture passer through the graft (black arrow) (B) and tied (C).

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  Fig 8. Intraoperative photograph of a right hip. A suture limb of the most medial anchor is passed in a piercing fashion using a Scorpion (Arthrex) suture passer (black arrow) through the graft.

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  Fig 9. Arthroscopic image of a right hip as viewed through the anterolateral portal. Third anchor is placed through the midanterior portal in the lateral extension of the defect and sutures are passed in a piercing fashion using a Scorpion (Arthrex) suture passer through the graft (A) and tied (B). (LG, labral graft; DG, dermal graft).