Allocation of Anchors During Labral Repair: A Multicenter Cohort Analysis of Labral Treatment in Hip Arthroscopy.

Background: While previous studies have established several techniques for suture anchor repair of the acetabular labrum to bone during arthroscopic surgery, the current literature lacks evidence defining the appropriate number of suture anchors required to effectively restore the function of the labral tissue.
Purpose/hypothesis: To define the location and size of labral tears identified during hip arthroscopy for acetabular labral treatment in a large multicenter cohort. The secondary purpose was to differentiate the number of anchors used during arthroscopic labral repair. The hypothesis was that the location and size of the labral tear as well as the number of anchors identified would provide a range of fixation density per acetabular region and fixation method to be used as a guide in performing arthroscopic repair.
Study Design: Cross-sectional study; Level of evidence, 3.
Methods: We used a multicenter registry of prospectively collected hip arthroscopy cases to find patients who underwent arthroscopic labral repair by 1 of 7 orthopaedic surgeons between January 2015 and January 2017. The tear location and number of anchors used during repair were described using the clockface method, where 3 o'clock denoted the anterior extent of the tear and 9 o'clock the posterior extent, regardless of sidedness (left or right). Tear size was denoted as the number of "hours" spanned per clockface arc. Chi-square and univariate analyses of variance were performed to evaluate the data for both the entire group and among surgical centers.
Results: A total of 1978 hips underwent arthroscopic treatment of the acetabular labrum; the most common tear size had a 3-hour span (n = 820; 41.5%). Of these hips, 1645 received labral repair, with most common repair location at the 12- to 3-o'clock position (n = 537; 32.6%). The surgeons varied in number of anchors per repair according to labral size ( P < .001 for all), using 1 to 1.6 anchors for 1-hour tears, 1.7 to 2.4 anchors for 2-hour tears, 2.1 to 3.2 anchors for 3-hour tears, and 2.2 to 4.1 for 4-hour tears.
Conclusion: Variation existed in the number of anchor implants per tear size. When labral repair involved a mean clockface arc >2 hours, at least 2 anchor points were fixated.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: J.J.C. has received faculty/speaking fees and royalties from Arthrex and Breg. S.J.N. has received consulting fees from Ossur and Stryker (paid to institution) and royalties from Stryker. A.B.W. has received education payments and consulting fees from Allosource and Stryker. J.P.S. has received education payments from Liberty Surgical, consulting fees from Stryker, and hospitality payments from Arthrosurface and Arthrex. D.M. has received consulting fees from Zimmer Biomet and royalties from Arthrocare and Smith & Nephew. T.J.E. has received education payments from Arthrex and Medacta and consulting fees and honoraria from Medacta. A.J.S. has received education payments from Arthrex, educational consulting fees from Smith & Nephew, and royalties from Thieme; has stock/stock options in Johnson & Johnson; and holds patents US12398960 and US14457743. D.S.C. has received research grants from Arthrex and consulting fees, speaking fees, and royalties from ConMed Linvatec and Zimmer Biomet. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
(© The Author(s) 2021.)