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Histologic assessment of acetabular labrum healing

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Abstract
Purpose: The purpose of this study was to histologically examine the human healing response of arthroscopically repaired acetabular labrum tears. Methods: Biopsy specimens were retrieved from 6 patients during total hip arthroplasty after clinical failure of the index arthroscopic procedure. All patients were diagnosed as having femoroacetabular impingement with a concomitant labral tear. In all cases severe chondral damage was observed during arthroscopy (Beck grades 3 to 4). Despite successful technical repair of the labral tear, chondral damage in these patients was so advanced that the clinical progress after the procedure was unsatisfactory and arthroplasty of the joint was required. Biopsy specimens of the repaired acetabular labra were harvested during the arthroplasty surgery and processed for standard histologic evaluation. Results: Macroscopically and histologically, all repaired labra kept their triangular shape more or less and appeared to have healed. All harvested biopsy specimens displayed a typical fibrocartilaginous appearance with limited vascular supply. Calcifications were present in only 1 biopsy specimen. In 3 cases neovascularization of the labral tissue was noticed in the proximity of the sutures. In the superficial and deep parts of the labral body, small clefts were observed in all cases. Conclusions: In this study the histologic aspects of arthroscopically repaired human labral tears were addressed. It was shown that human labral tears show healing potential after surgical repair. The surfaces of the labral tissues were intact, and neither remnants of the tear nor the presence of fibrovascular scar tissue was observed. However, some small clefts in the superior and deep parts of the repaired structures were noticed in all cases. Level of Evidence: Level IV, therapeutic case series.
Keywords
FEMOROACETABULAR IMPINGEMENT, TEARS, CARTILAGE, REPAIR, SEAL, ARTHROSCOPY, FINITE-ELEMENT MODEL, HIP-JOINT

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Chicago
Audenaert, Emmanuel, Aad Dhollander, Ramses Forsyth, Kristoff Corten, August Verbruggen, and Christophe Pattyn. 2012. “Histologic Assessment of Acetabular Labrum Healing.” Arthroscopy-the Journal of Arthroscopic and Related Surgery 28 (12): 1784–1789.
APA
Audenaert, E., Dhollander, A., Forsyth, R., Corten, K., Verbruggen, A., & Pattyn, C. (2012). Histologic assessment of acetabular labrum healing. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 28(12), 1784–1789.
Vancouver
1.
Audenaert E, Dhollander A, Forsyth R, Corten K, Verbruggen A, Pattyn C. Histologic assessment of acetabular labrum healing. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY. 2012;28(12):1784–9.
MLA
Audenaert, Emmanuel, Aad Dhollander, Ramses Forsyth, et al. “Histologic Assessment of Acetabular Labrum Healing.” ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 28.12 (2012): 1784–1789. Print.
@article{4262042,
  abstract     = {Purpose: The purpose of this study was to histologically examine the human healing response of arthroscopically repaired acetabular labrum tears.
Methods: Biopsy specimens were retrieved from 6 patients during total hip arthroplasty after clinical failure of the index arthroscopic procedure. All patients were diagnosed as having femoroacetabular impingement with a concomitant labral tear. In all cases severe chondral damage was observed during arthroscopy (Beck grades 3 to 4). Despite successful technical repair of the labral tear, chondral damage in these patients was so advanced that the clinical progress after the procedure was unsatisfactory and arthroplasty of the joint was required. Biopsy specimens of the repaired acetabular labra were harvested during the arthroplasty surgery and processed for standard histologic evaluation.
Results: Macroscopically and histologically, all repaired labra kept their triangular shape more or less and appeared to have healed. All harvested biopsy specimens displayed a typical fibrocartilaginous appearance with limited vascular supply. Calcifications were present in only 1 biopsy specimen. In 3 cases neovascularization of the labral tissue was noticed in the proximity of the sutures. In the superficial and deep parts of the labral body, small clefts were observed in all cases.
Conclusions: In this study the histologic aspects of arthroscopically repaired human labral tears were addressed. It was shown that human labral tears show healing potential after surgical repair. The surfaces of the labral tissues were intact, and neither remnants of the tear nor the presence of fibrovascular scar tissue was observed. However, some small clefts in the superior and deep parts of the repaired structures were noticed in all cases.
Level of Evidence: Level IV, therapeutic case series.},
  author       = {Audenaert, Emmanuel and Dhollander, Aad and Forsyth, Ramses and Corten, Kristoff and Verbruggen, August and Pattyn, Christophe},
  issn         = {0749-8063},
  journal      = {ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY},
  keyword      = {FEMOROACETABULAR IMPINGEMENT,TEARS,CARTILAGE,REPAIR,SEAL,ARTHROSCOPY,FINITE-ELEMENT MODEL,HIP-JOINT},
  language     = {eng},
  number       = {12},
  pages        = {1784--1789},
  title        = {Histologic assessment of acetabular labrum healing},
  url          = {http://dx.doi.org/10.1016/j.arthro.2012.06.012},
  volume       = {28},
  year         = {2012},
}

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