title: Evaluation of the sealing function of the acetabular labrum: an in vitro biomechanical study.
abstract: OBJECTIVE
  To quantitatively evaluate the biomechanical sealing function of an intact labrum and the effect of labral-chondral separation, cerclage suture labral repair, vertical mattress suture repair and partial labrectomy on distraction load and hip joint centre (HJC) displacement.
  
  
  METHODS
  Eight fresh-frozen cadaveric hips were tested using a navigation system for intra-operative kinematic analysis. A six-axis load cell was used to measure the manually applied force when performing the tests: hip pivoting movement and distraction. The HJC displacement that occurred during the distraction test has been evaluated in correspondence of seven different values of applied force. During the pivoting motion, the maximum value of HJC displacement was evaluated. Five different conditions were tested: labrum intact, labral-chondral separation, vertical mattress suture repair, cerclage suture repair, and partial labrectomy.
  
  
  RESULTS
  With regard to HJC displacement using at fixed value of force, the paired sample t test underscored the statistically significant differences (p < 0.05) for each of the five tested conditions among themselves. Only the comparison of intact versus labral-chondral separation was not significantly different. During pivoting motion, a statistically significantly greater displacement was identified after labrectomy when compared with the cerclage suture repair (p = 0.03) and vertical mattress repair (p < 0.01) in medial-lateral direction. Along proximal-distal direction, a significant lower displacement after labrectomy was identified when compared to the cerclage suture repair (p = 0.03). Performing the pivoting motion at the extreme ranges of motion demonstrated a higher value of displacement after labrectomy when compared with all the previously tested conditions.
  
  
  CONCLUSIONS
  These results suggest that labral repair is important in the function of the hip and that the vertical mattress suture technique may be better than the cerclage suture repair.
authors.affiliation: Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy. c.signorelli@biomec.ior.it.
authors.forename: C
authors.initials: C
authors.lastname: Signorelli
authors.affiliation: Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.|Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Bonanzinga
authors.affiliation: Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.|Dipartimento di Ingegneria dell'Informazione, Università degli Studi di Brescia, Via Branze 38, 25123, Brescia, BS, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Lopomo
authors.affiliation: Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.|Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Zaffagnini
authors.affiliation: Laboratorio di Biomeccanica ed Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via Di Barbiano 1/10, Bologna, BO, Italy.|Clinica Ortopedica e Traumatologica II, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna, BO, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Marcacci
authors.affiliation: Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Safran
mesh_terms: D000077:Acetabulum / Q000503:physiopathology / Q000601:surgery*; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D002358:Cartilage, Articular / Q000503:physiopathology / Q000601:surgery; D005260:Female; D051445:Fibrocartilage / Q000503:physiopathology / Q000601:surgery; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D013536:Suture Techniques
keywords: Controlled load; HJC displacement; Labral repair; Labral–chondral separation; Labrectomy