Background Many advances have been made in hip labral repair and reconstruction and in the restoration of the suction seal. Purpose/Hypothesis The purpose of this study was to evaluate the biomechanical effects of segmental labral reconstruction with a synthetic polyurethane scaffold (PS) in comparison with segmental labrectomy. Our hypothesis was that reconstruction with a icroporous polyurethane implant would normalize joint kinetics of the hip and restore the suction seal. Study Design Controlled laboratory study. Methods We used 10 hips from 5 fresh-frozen pelvises with an intact acetabular labrum without osteoarthritis. Using an intra-articular pressure measurement system, the contact area, contact pressure, and peak force were assessed for the following conditions: intact labrum, partial anterosuperior labrectomy, and PS reconstruction. For each condition, all specimens were analyzed in 4 positions (90° of flexion, 90° of flexion and internal rotation, 90° of flexion and external rotation, and 20° of extension) and underwent a labral seal test. The relative change from the intact condition was determined for all conditions and positions. Results Compared with the intact labrum, labrectomy resulted in a significant decrease in the contact area (P < .001) and a significant increase in the peak force (P < .001) and contact pressure (P < .001) across all positions. Compared with labrectomy, PS reconstruction resulted in a significant increase in the contact area (P < .001) and a significant decrease in the contact pressure (P ≤ .02) and peak force (P < .001) across all positions. Compared with the intact labrum, PS reconstruction restored the contact area and peak force to normal values in all positions (P > .05), whereas the contact pressure was significantly decreased compared with labrectomy (P < .05) but did not return to normal values. The labral seal was lost in all specimens after labrectomy but was restored in 80% of the specimens after PS reconstruction. Conclusion Femoroacetabular contact biomechanics significantly worsened after partial labrectomy; reconstruction using a PS restored the contact area and peak force to the intact state and improved the contact pressure increases seen after partial labrectomy. The contact area and peak force were normalized, and the labral seal was re-established in most cases. Clinical Relevance This study provides biomechanical evidence for the use of a scaffold for labral reconstruction.

中文翻译：

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用聚氨酯支架重建髋盂唇：股骨髋臼接触生物力学的恢复。

背景 在髋盂唇修复和重建以及吸引密封的恢复方面已经取得了许多进展。目的/假设 本研究的目的是评估与节段性盂唇切除术相比，使用合成聚氨酯支架 (PS) 进行节段性盂唇重建的生物力学效果。我们的假设是，使用微孔聚氨酯植入物进行重建将使髋关节动力学正常化并恢复抽吸密封。研究设计 受控实验室研究。方法 我们使用来自 5 个新鲜冷冻骨盆的 10 个髋关节，髋臼盂唇完整，无骨关节炎。使用关节内压力测量系统，评估以下条件的接触面积、接触压力和峰值力：完整的盂唇、部分前上盂唇切除术和 PS 重建。对于每种情况，所有样本都在 4 个位置（90° 屈曲、90° 屈曲和内旋、90° 屈曲和外旋以及 20° 伸展）进行了分析，并进行了盂唇密封测试。对于所有条件和位置，确定了与完整条件的相对变化。结果与完整的盂唇相比，盂唇切除术导致所有位置的接触面积显着减少（P < .001），峰值力（P < .001）和接触压力（P < .001）显着增加。与唇切除术相比，PS 重建导致接触面积显着增加 (P < .001)，所有位置的接触压力 (P ≤ .02) 和峰值力 (P < .001) 显着降低。与完整的盂唇相比，PS重建使所有位置的接触面积和峰值力恢复到正常值（P > .05），而与唇切除术相比，接触压力显着降低（P < .05），但没有恢复到正常值。盂唇切除术后所有标本的盂唇密封丢失，但 PS 重建后 80% 的标本恢复。结论 部分盂唇切除术后股骨髋臼接触生物力学明显恶化；使用 PS 进行重建将接触面积和峰值力恢复到完整状态，并改善了部分盂唇切除术后的接触压力增加。接触面积和峰值力被归一化，并且在大多数情况下重新建立了盂唇密封。临床相关性 本研究为使用支架进行盂唇重建提供了生物力学证据。