Clin Orthop Surg.  2017 Dec;9(4):405-412. 10.4055/cios.2017.9.4.405.

Factors Associated with the Risk of Articular Surface Perforation during Anchor Placement for Arthroscopic Acetabular Labral Repair

• Yoo JI
• Ha YC
• Hwang SC
• Oh JY
• Chang EC
• Lee YK
• Koo KH

• KMID: 2412240
• DOI: http://doi.org/10.4055/cios.2017.9.4.405

Abstract

BACKGROUND
The purpose of this study was to evaluate factors associated with the risk of articular surface perforation during anchor placement for arthroscopic acetabular labral repair using follow-up computed tomographic arthrography (CTA).
METHODS
Forty-six patients (29 males and 17 females) underwent arthroscopic labral repair using 142 suture anchors (55 large anchors and 87 small anchors). The patients were followed with CTA 1 year postoperatively. Anchor position was assessed by the insertion angle and the distance of the suture anchor tip from the articular cartilage. The incidence of malposition of suture anchors was assessed in follow-up CTA. The location and incidence of malposition were compared between two groups divided according to the diameter of suture anchor.
RESULTS
The mean insertion angle and distance were significantly different between the groups. Of the 142 anchors, 15 (11%) were placed in the cartilage-bone transitional zone. Articular involvement was most common at the 3 o'clock position of the suture anchor (six out of 33 anchors, 18.2%). Both the insertion angle and distance showed small values in the articular involvement group.
CONCLUSIONS
The radiographic analysis of the placement of suture anchors after arthroscopic labral refixation based on follow-up CTA demonstrates that articular involvement of anchors is related to the location on the acetabular rim (clock position) and anchor diameter.

Keyword

Acetabulum; Suture anchors; Risk factor

MeSH Terms

Acetabulum/diagnostic imaging/*surgery
Adult
Arthrography
Arthroscopy/adverse effects
Cartilage, Articular/diagnostic imaging/*injuries
Female
Hip Joint/diagnostic imaging/*surgery
Humans
Male
Middle Aged
Prosthesis Implantation/*adverse effects
Retrospective Studies
Risk Factors
Suture Anchors/*adverse effects
Tomography, X-Ray Computed
Young Adult

Figure

• 

  Fig. 1 PEEK standard anchors: 2.3-mm Bioraptor suture anchor (Smith & Nephew, Andover, MA, USA) (A) and 2.9-mm Bioraptor knotless suture anchor (Smith & Nephew) (B). All-suture type soft anchors: 1.3-mm Y-Knot (ConMed Linvatec, Largo, FL, USA) (C) and 1.4-mm JuggerKnot (BIOMET, Warsaw, IN, USA) (D).

• 

  Fig. 2 Radiological measurements. (A) Coronal, axial, and sagittal computed tomographic arthrography reconstruction. (B) Lateral center edge angle (LCEA: the angle formed by a vertical line and a line connecting the center of the femoral head with the lateral edge of the acetabulum). (C) Location of each anchor according to the clock position.

• 

  Fig. 3 Parameters assessed using computed tomographic arthrography. (A) Insertion angle of the suture anchor (yellow arrow). It was measured by extending a line 15 mm from the insertion point to the acetabular cartilage and drawing a second line through the anchor. (B) Distance from the tip of the suture anchor (yellow arrow). It was measured as the minimum distance between the anchor/drill hole and the articular surface of the acetabulum. (C) Malposition of suture anchors at the cartilage-bone transitional zone (white arrow).

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