Circumferential Labral Reconstruction With Knotless All-Suture Anchors Restores Hip Distractive Stability: A Cadaveric Biomechanical Analysis
Authors: Lall AC, Smith BL, Kahana-Rojkind AH, Khoury AN, Wijdicks CA, Domb BG
DOI Link: 10.1177/03635465241287146
Journal: American Journal of Sports Medicine, 2024
Objective
To assess whether circumferential labral reconstruction (CLR) using knotless all-suture anchors (ASAs) can restore distractive stability in the hip joint in a cadaveric model.
Methodology
Eight cadaveric hips were tested under four conditions: intact labrum, labral excision, CLR with moderate tension, and CLR with high tension. Suction seal strength and distractive stability were measured using peak force metrics.
Key Findings
- CLR with ASAs restored approximately 82% of the native suction seal.
- Labral excision significantly compromised hip joint stability.
- Increased tension in the reconstruction did not result in improved stability over moderate tension.
- A more acute bevel angle on the acetabular rim improved suction seal reconstitution.
Conclusion
Circumferential labral reconstruction using knotless ASAs is biomechanically effective at restoring joint stability and preserving bone. It may be a favorable technique in cases requiring complete labral replacement.
What Does This Mean for Providers?
For surgeons treating complex labral pathology or performing revision hip arthroscopy, CLR with knotless ASAs offers a viable solution to restore hip stability. The data suggest moderate graft tension is sufficient, and acetabular preparation—including beveling—plays a critical role in optimizing suction seal restoration. This technique preserves native bone and may reduce the risk of over-constraining the joint compared to high-tension repairs.