PMC4718472_01
Supine arthroscopic image of right hip from anterolateral portal showing acetabular chondral elevation adjacent to the labral repair with suture anchor fixation.
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Andover, MA, USA) placed via the mid-anterior portal. After placement of the suture anchors, inspection of the acetabular cartilage revealed focal ballooning of the articular chondral surface adjacent to the labral repair (Fig. 1).
Post-operative AP radiograph of right hip. Note well-preserved joint.
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Two-year follow-up revealed improvement of modified Harris Hip Score Hip (mHHS) (from 67 to 96), Hip Outcome Score Daily Activity Part 1 (from 88 to 100) and Sport Specific Part 2 (from 33 to 86) and post-operative radiographs revealed joint space preservation (Fig. 2).
PMC4718472_02
PMC4718472_03
Supine arthroscopic image from anterolateral portal of left hip during establishment of modified mid-anterior portal (note entry needle and stylet). One can see an exposed hard anchor (arrow) that has penetrated the anterior acetabular articular cartilage. Ac, acetabulum, FH, femoral head.
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Intra-operatively, the previously burr-resected side of the anchor was exposed at the level of the adjacent chondral surfaces (Fig. 3) but not loose.
Arthroscopic image of left hip showing a microfracture awl displacing the embedded but exposed anchor.
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The anchor was dislodged using a microfracture awl and subsequently removed with a grasper through an 8-mm arthroscopic cannula without incident (Fig. 4).
Arthroscopic image of left hip after anchor removal and microfracture chondroplasty. Ac, acetabulum, FH, femoral head.
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The remaining trough was treated with microfracture chondroplasty (Fig. 5).
PMC4718472_04
PMC4718472_05
Supine arthroscopic image of right hip from anterolateral portal showing extensive acetabular chondral damage from one (arrow) of two penetrating hard anchors. Ant, anterior, Sup, superior.
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During revision hip arthroscopy, both of her previous anchors for her labral repair were found to have penetrated her subchondral bone, had become intra-articular, and significantly damaged the cartilage on the acetabulum at the 12 o'clock and 2 o'clock positions (Fig. 6).