Labral penetration rate in a consecutive series of 300 hip arthroscopies.

BACKGROUND

Intraoperative labral injury during the establishment of the first portal in hip arthroscopy has been reported to be as high as 20%.

PURPOSE: The purpose of the study was to prospectively identify the incidence of acetabular labral injuries that occurred while using a current technique for the establishment of portals during hip arthroscopy.

STUDY

DESIGN

Case series; Level of evidence, 4.

METHODS

Between the years 2008 and 2010, data were prospectively collected for all patients undergoing hip arthroscopic surgery. Patients with previous labral resection or Tonnis grade greater than 1 were excluded. Patients were positioned supine, traction was applied, and portals were established. The anterolateral portal was created first by venting the joint with a spinal needle and then re-entering the joint with the same needle with the bevel side facing the labrum. Next, the midanterior portal was created under vision. A thorough examination of the acetabular labrum was conducted arthroscopically through multiple viewing portals, and labral injuries related to the establishment of portals were identified and noted.

RESULTS

A total of 300 patients were included in the study; only 2 patients (0.67%) suffered intraoperative labral injuries at the study period. One injury occurred during revision arthroscopy, while the second involved a hyperplastic labrum in a dysplastic hip. No patient with normal hip morphological characteristics undergoing a hip arthroscopy suffered a labral tear as a result of portal placement.

CONCLUSION

The incidence of iatrogenic labral injury during hip arthroscopy can be as low as 0.67% when using the described technique.