Graft Height and Labral Integrity as Key Determinants of Suction Seal Restoration in Hip Labral Augmentation: Findings From an Ovine Model
Selahaddin Aydemir, Joseph Featherall, Mazen Mohamed Ibrahim, Reşit Buğra Husemoğlu, Eren Akın, Ümit Ali Karabağ, Onur HapaBackground:
The acetabular labrum plays a critical role in maintaining the hip suction seal, joint stability, and load distribution. When primary repair is not feasible, augmentation is preferred if the chondrolabral junction can be preserved, whereas reconstruction is performed when it cannot. However, biomechanical studies evaluating the effects of graft geometry and labral preservation strategies on suction seal restoration remain limited.
Hypothesis/Purpose:
It was hypothesized that augmentation using an extended graft combined with partial labral preservation would restore femoroacetabular suction seal strength more effectively than standard reconstruction after labrum excision. This study compared the biomechanical outcomes of different graft labral height and preservation width configurations in an ovine hip model.
Study Design:
Controlled laboratory study.
Methods:
A total of 48 fresh-frozen ovine hemipelvises were randomized into 6 groups (n = 8) according to labral preservation width, excision pattern, and graft radial height. Autologous extensor tendon grafts with standard or extended labral height were fixed to standardized segmental defects using suture anchors. The suction seal force was defined as the linear distraction force required to disrupt the femoroacetabular seal and measured in intact, excised, and reconstructed states. Restoration was defined as deviation from the intact condition and improvement relative to the excised state. Intergroup comparisons were performed using nonparametric tests with Bonferroni correction (
Results:
The configuration combining one-third native labral preservation with an extended graft demonstrated the smallest deviation from the intact condition (3.8 N) and the greatest improvement relative to the excised state (18 N), showing significant superiority compared with the total excision plus standard graft construct (
Conclusion/Clinical Relevance:
Partial labral preservation combined with increased graft labral height provided the most favorable biomechanical restoration of femoroacetabular suction seal strength.