Good day. This talk is on capsular autograph label reconstruction with minimum two-year follow-up. I would like to thank my co-authors for their contribution to this. I have no financial disclosures related to this topic. Prior studies have shown superior results of arthroscopic label repair compared to debrisment. If the labrum is deficient and not amendable to simple repair, reconstruction techniques are indicated. There are numerous publications on the successful use of remote autographs and allographs to reconstruct the labrum. The current study uses a novel surgical technique utilizing local autographed capsular tissue to reconstruct the labrum. No previous study has reported functional outcome for patients with label reconstruction using this technique. This study is a retrospective case series of prospectively collected data from 2013 to 2018. Included were patients who underwent primary hip arthroscopy for capsular autograph label reconstruction with a minimum of two-year follow-up. The surgical technique includes elevating the capsule 7-10 mm above the capsule labral junction to the acetabular edge using a knife rasp while preserving the labral blood supply. If overcoverage exists, it is treated concomitantly with acetabular osteoplasty, taking great care to preserve the remaining chondral labral junction. This example reveals a decimated labrum on the right hip with a chondral flap. This patient underwent fixation which is carried out using biocomposite anchors with a loop suture technique around the remaining native labrum and elevated capsule. This picture shows a completed capsule repair from the peripheral compartment showing reconstruction of the labral seal and reconstitution of the labral seal with an inground repair. This is an example of an out-of-round repair with anchors placed too proximally from the acetabular edge which leads to an eccentric repair along with over-tensioning and eversion of the labrum when securing knots. Demographics included a mean age of 39 and a minimum follow-up of two years. The large majority of the patients had concomitant femoral acetabular impingement. Medical findings included grade 2 and 3 otter bridge cartilage lesions in 78% of the patients. The large majority of the patients underwent concomitant femoral acetabular osteoplasty or impingement. 80% of the patients had significant functional improvement from baseline to follow-up reaching MCID threshold. In addition, significant improvement was also noted for the hip outcome sport-specific subscale. We also performed a subgroup analysis comparing patients who had capsular elevation equal to or less than 7 mm or over 7 mm above the location of the labral reconstruction. We found no difference in outcomes between these patients. Examinations included two neuropraxies and six patients with heriotopic ossification that was sliver-like and located at the site of the elevation and did not affect motion. No patient developed joint instability. Advantages of the technique included the use of local autograft tissue which minimizes donor site morbidity. In addition, the remaining labral tissue and chondrolabral junction is preserved and assists in maintaining stability and providing the in-round repair reconstruction of labrum. Disadvantages included the lack of long-term follow-up and the procedure warrants biomechanical testing to determine the stability of the reconstruction. In conclusion, capsular autograft labral reconstruction can be used as an effective tool to reconstruct labrums that are not amenable to simple repair with favorable results at over two-year follow-up. The procedure maintains the labral seal, preserves the remaining chondrolabral junction, prevents an out-of-round repair, and preserves blood supply and stability of the hip. Thank you.

surgical technique

capsular autograft labral reconstruction

labrum deficiencies

local autograft tissue

functional improvement