Arthroscopic treatment of irreducible hip posterior dislocation caused by acetabular labrum bony Bankart lesions_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 ZHAO Daohong ¹ , HU Weiping ² , ZHAO Bo ³ , ZHAO Xinghai ⁴ , LI Yan ⁴ , ZHANG Jun ¹ , CHEN Hong ⁵ , WU Zhidan ¹

1. Department of Orthopedics, the Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650101, P.R.China;
2. Department of Orthopedics, the People’s Hospital of Zhenxiong County, Zhenxiong Yunnan, 657200, P.R.China;
3. Department of Orthopedics, the Second People’s Hospital of Baoshan City, Baoshan Yunnan, 678000, P.R.China;
4. Department of Orthopedics, the First People’s Hospital of Dehong State, Dehong Yunnan, 678400, P.R.China;
5. Department of Orthopedics, the First People’s Hospital of Kunming, Kunming Yunnan, 650000, P.R.China;

Corresponding author：

ZHAO Daohong, Email: 381454239@qq.com

Keywords：

Arthroscopy; hip dislocation; acetabular labrum lesion; bony Bankart lesion

DOI：

10.7507/1002-1892.201901059

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Objective To investigate the effectiveness of arthroscopic treatment for irreducible hip posterior dislocation caused by acetabular labrum bony Bankart lesions.Methods Between February 2008 and August 2016, 11 patients with irreducible hip posterior dislocation caused by acetabular labrum bony Bankart lesions, were treated with arthroscopic reduction and fixation of bony Bankart lesions. There were 7 males and 4 females, with an average age of 23.7 years (mean, 15-36 years). The injury was caused by traffic accident in 8 cases and falling from height in 3 cases. The interval between hip dislocation and the first manual reduction was 2-8 hours (mean, 5.3 hours) and between the first manual reduction and arthroscopic surgery was 6-31 days (mean, 12.8 days). The preoperative visual analogue scale (VAS) was 5.2±0.9, the modified Harris score was 32±8, and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) was 30±5. Results The operative time was 90-150 minutes (mean, 120.9 minutes), with no hip arthroscopic surgery related complications. All incisions healed by first intention. All patients were followed up 26-68 months (mean, 42.7 months). Postoperative X-ray films showed that all hip joints were reduction; CT showed that the reduction of posterior acetabular wall fracture was satisfactory. And all fractures healed at last follow-up with no avascular necrosis of the femoral head or osteoarthritis. At last follow-up, the VAS score was 0.5±0.5, the modified Harris score was 94±5, and the WOMAC score was 95±4. There were significant differences in those indexes between pre- and post-operation (P<0.05). Conclusion The irreducible hip posterior dislocation caused by acetabular labrum bony Bankart lesions is rare. Arthroscopic therapy has the advantages of less trauma, quick recovery, and less complications.

Citation： ZHAO Daohong, HU Weiping, ZHAO Bo, ZHAO Xinghai, LI Yan, ZHANG Jun, CHEN Hong, WU Zhidan. Arthroscopic treatment of irreducible hip posterior dislocation caused by acetabular labrum bony Bankart lesions. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(6): 676-680. doi: 10.7507/1002-1892.201901059 Copy

1.	Begly JP, Robins B, Youm T. Arthroscopic treatment of traumatic hip dislocation. J Am Acad Orthop Surg, 2016, 24(5): 309-317.
2.	Morris AC, Yu JC, Gilbert SR. Arthroscopic treatment of traumatic hip dislocations in children and adolescents: A preliminary study. J Pediatr Orthop, 2017, 37(7): 435-439.
3.	Niroopan G, de Sa D, MacDonald A, et al. Hip arthroscopy in trauma: A systematic review of indications, efficacy, and complications. Arthroscopy, 2016, 32(4): 692-703.
4.	Canale ST, Manugian AH. Irreducible traumatic dislocations of the hip. J Bone Joint Surg (Am), 1979, 61(1): 7-14.
5.	Dameron TB Jr. Bucket-handle tear of acetabular labrum accompanying posterior dislocation of the hip. J Bone Joint Surg (Am), 1959, 41-A(1): 131-134.
6.	Paterson I. The torn acetabular labrum: a block to reduction of a dislocated hip. J Bone Joint Surg (Br), 1957, 39-B(2): 306-309.
7.	Chun KA, Morcuende J, El-Khoury GY. Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child. Skeletal Radiol, 2004, 33(12): 728-731.
8.	Burgos J, Gonzalez-Herranz P, Ocete G. Traumatic hip dislocation with incomplete reduction due to soft tissue interposition in a 4-year-old boy. J Pediatr Orthop, 1995, 4(2): 216-218.
9.	Mullis BH, Dahners LE. Hip arthroscopy to remove loose bodies after traumatic dislocation. J Orthop Trauma, 2006, 20(1): 22-26.
10.	Park MS, Yoon SJ, Choi SM. Hip arthroscopic management for femoral head fractures and posterior acetabular wall fractures (Pipkin type Ⅳ). Arthrosc Tech, 2013, 2(3): e221-e225.
11.	Sozen YV, Polat G, Kadioglu B, et al. Arthroscopic bullet extraction from the hip in the lateral decubitus position. Hip Int, 2010, 20(2): 265-268.
12.	Birmingham P, Cluett J, Shaffer B. Recurrent posterior dislocation of the hip with a bankart-type lesion: a case report. Am J Sports Med, 2010, 38(2): 388-391.
13.	Wylie JD, Abtahi AM, Beckmann JT, et al. Arthroscopic and imaging findings after traumatic hip dislocation in patients younger than 25 years of age. J Hip Preserv Surg, 2015, 2: 303-309.
14.	Hwang JM, Hwang DS, Lee WY, et al. Hip arthroscopy for incarcerated acetabular labrum following reduction of traumatic hip dislocation: Three case reports. Hip Pelvis, 2016, 28(3): 164-168.
15.	Harnroongroj T, Suangyanon P, Tharmviboonsri T, et al. Posterior acetabular arc angle of the femoral head assesses instability of posterior fracture-dislocation of the hip. Int Orthop, 2013, 37(6): 1141-1145.
16.	Ilizaliturri VM Jr, Gonzalez-Gutierrez B, Gonzalez-Ugalde H, et al. Hip arthroscopy after traumatic hip dislocation. Am J Sports Med, 2011, 39 Suppl: 50S-57S.
17.	Cross MB, Shindle MK, Kelly BT. Arthroscopic anterior and posterior labral repair after traumatic hip dislocation: case report and review of the literature. HSS J, 2010, 6(2): 223-227.
18.	Svoboda SJ, Williams DM, Murphy KP. Hip arthroscopy for osteochondral loose body removal after a posterior hip dislocation. Arthroscopy, 2003, 19(7): 777-781.
19.	Yamamoto Y, Ide T, Ono T, et al. Usefulness of arthroscopic surgery in hip trauma cases. Arthroscopy, 2003, 19(3): 269-273.
20.	Bozic KJ, Chan V, Valone FH 3rd, et al. Trends in hip arthroscopy utilization in the United States. J Arthroplasty, 2013, 28(8 Suppl): 140-143.
21.	Rashleigh-Belcher HJ, Cannon SR. Recurrent dislocation of the hip with a " Bankart-type” lesion. J Bone Joint Surg (Br), 1986, 68(3): 398-399.
22.	Stabile KJ, Neumann JA, Mannava S, et al. Arthroscopic treatment of bucket-handle labral tear and acetabular fracture. Arthrosc Tech, 2014, 3(2): e283-e287.

1. Begly JP, Robins B, Youm T. Arthroscopic treatment of traumatic hip dislocation. J Am Acad Orthop Surg, 2016, 24(5): 309-317.
2. Morris AC, Yu JC, Gilbert SR. Arthroscopic treatment of traumatic hip dislocations in children and adolescents: A preliminary study. J Pediatr Orthop, 2017, 37(7): 435-439.
3. Niroopan G, de Sa D, MacDonald A, et al. Hip arthroscopy in trauma: A systematic review of indications, efficacy, and complications. Arthroscopy, 2016, 32(4): 692-703.
4. Canale ST, Manugian AH. Irreducible traumatic dislocations of the hip. J Bone Joint Surg (Am), 1979, 61(1): 7-14.
5. Dameron TB Jr. Bucket-handle tear of acetabular labrum accompanying posterior dislocation of the hip. J Bone Joint Surg (Am), 1959, 41-A(1): 131-134.
6. Paterson I. The torn acetabular labrum: a block to reduction of a dislocated hip. J Bone Joint Surg (Br), 1957, 39-B(2): 306-309.
7. Chun KA, Morcuende J, El-Khoury GY. Entrapment of the acetabular labrum following reduction of traumatic hip dislocation in a child. Skeletal Radiol, 2004, 33(12): 728-731.
8. Burgos J, Gonzalez-Herranz P, Ocete G. Traumatic hip dislocation with incomplete reduction due to soft tissue interposition in a 4-year-old boy. J Pediatr Orthop, 1995, 4(2): 216-218.
9. Mullis BH, Dahners LE. Hip arthroscopy to remove loose bodies after traumatic dislocation. J Orthop Trauma, 2006, 20(1): 22-26.
10. Park MS, Yoon SJ, Choi SM. Hip arthroscopic management for femoral head fractures and posterior acetabular wall fractures (Pipkin type Ⅳ). Arthrosc Tech, 2013, 2(3): e221-e225.
11. Sozen YV, Polat G, Kadioglu B, et al. Arthroscopic bullet extraction from the hip in the lateral decubitus position. Hip Int, 2010, 20(2): 265-268.
12. Birmingham P, Cluett J, Shaffer B. Recurrent posterior dislocation of the hip with a bankart-type lesion: a case report. Am J Sports Med, 2010, 38(2): 388-391.
13. Wylie JD, Abtahi AM, Beckmann JT, et al. Arthroscopic and imaging findings after traumatic hip dislocation in patients younger than 25 years of age. J Hip Preserv Surg, 2015, 2: 303-309.
14. Hwang JM, Hwang DS, Lee WY, et al. Hip arthroscopy for incarcerated acetabular labrum following reduction of traumatic hip dislocation: Three case reports. Hip Pelvis, 2016, 28(3): 164-168.
15. Harnroongroj T, Suangyanon P, Tharmviboonsri T, et al. Posterior acetabular arc angle of the femoral head assesses instability of posterior fracture-dislocation of the hip. Int Orthop, 2013, 37(6): 1141-1145.
16. Ilizaliturri VM Jr, Gonzalez-Gutierrez B, Gonzalez-Ugalde H, et al. Hip arthroscopy after traumatic hip dislocation. Am J Sports Med, 2011, 39 Suppl: 50S-57S.
17. Cross MB, Shindle MK, Kelly BT. Arthroscopic anterior and posterior labral repair after traumatic hip dislocation: case report and review of the literature. HSS J, 2010, 6(2): 223-227.
18. Svoboda SJ, Williams DM, Murphy KP. Hip arthroscopy for osteochondral loose body removal after a posterior hip dislocation. Arthroscopy, 2003, 19(7): 777-781.
19. Yamamoto Y, Ide T, Ono T, et al. Usefulness of arthroscopic surgery in hip trauma cases. Arthroscopy, 2003, 19(3): 269-273.
20. Bozic KJ, Chan V, Valone FH 3rd, et al. Trends in hip arthroscopy utilization in the United States. J Arthroplasty, 2013, 28(8 Suppl): 140-143.
21. Rashleigh-Belcher HJ, Cannon SR. Recurrent dislocation of the hip with a " Bankart-type” lesion. J Bone Joint Surg (Br), 1986, 68(3): 398-399.
22. Stabile KJ, Neumann JA, Mannava S, et al. Arthroscopic treatment of bucket-handle labral tear and acetabular fracture. Arthrosc Tech, 2014, 3(2): e283-e287.

Chinese Journal of Reparative and Reconstructive Surgery

Arthroscopic treatment of irreducible hip posterior dislocation caused by acetabular labrum bony Bankart lesions

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