Reconstruction of Massive Posterior Nonrepairable Acetabular Labral Tears With Peroneus Brevis Tendon Allograft: Arthroscopy-Assisted Mini-Open Approach  Esther Moya, M.D., Luis Gerardo Natera, M.D., Carlomagno Cardenas, M.D., Emanuele Astarita, M.D., Vittorio Bellotti, M.D., Manel Ribas, M.D.  Arthroscopy Techniques  Volume 5, Issue 5, Pages e1015-e1022 (October 2016) DOI: 10.1016/j.eats.2016.05.003 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 All panels show a left hip viewed with a 70° scope. (A) Arthroscopic dry view through the anterior mini-open approach. Shown is the hip distraction after applying traction to the extremity (white arrow). Retractors are placed surrounding the femoral neck (yellow arrow). (B) Fluoroscopic anteroposterior view under traction, in which the hip-joint distraction can be observed (white arrow). (C) Arthroscopic dry view through the anterior mini-open approach. Shown is the osteotomy of the acetabular bone in a pincer-case with an osteotome (white arrow). (D) Arthroscopic dry view through the anterior mini-open approach. Observe the fish mouth shape of the acetabular rim (white arrow), already prepared for the anchor placement. (E) Arthroscopic dry view through the anterior mini-open approach. Measurement of the labral defect (white arrow) before reconstruction. (F) Measurement of the peroneus brevis allograft before being implanted. Arthroscopy Techniques 2016 5, e1015-e1022DOI: (10.1016/j.eats.2016.05.003) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 All panels show a left hip viewed with a 70° scope. (A) Arthroscopic dry view through the anterior mini-open approach. Intra-articular inspection with a palpator to identify cartilage tears (white arrow) is shown. (B) Arthroscopic dry view through the anterior mini-open approach. Microfractures are performed according to technique of Steadman et al. (white arrow) under arthroscopic control. (C) Arthroscopic dry view through the anterior mini-open approach. Autologous fibrin is applied. (D) Arthroscopic dry view through the anterior mini-open approach. Observe that suture anchors have been placed in the acetabular rim. (E) Graft preparation. Sutures should be passed through the graft (white arrow) at the same distance that the anchors have between them at the acetabular rim (white arrow). (F) Detail of peroneus brevis allograft once the sutures have been passed through it. Observe that the distance between sutures passing through the graft (white arrow) is the same that the distance between the anchors that were previously placed at the acetabular rim (yellow arrow). Arthroscopy Techniques 2016 5, e1015-e1022DOI: (10.1016/j.eats.2016.05.003) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 All panels show a left hip viewed with a 70° scope. (A) Superior perspective of the mini-open approach, in which the descent of the graft through the sutures can be observed (yellow arrow). (B) Arthroscopic dry view through the anterior mini-open approach, in which graft placement at the acetabular rim (white arrow) and suturing with the proper tension can be observed. (C) Arthroscopic dry view through the anterior mini-open approach. Final view of the graft once placed and sutured (white arrow). (D) Arthroscopic dry view through the anterior mini-open approach. Shown is the bone bump on the head neck junction (white arrow). Arthroscopy Techniques 2016 5, e1015-e1022DOI: (10.1016/j.eats.2016.05.003) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 All panels show a left hip viewed with a 70° scope. (A) Arthroscopic dry view through the anterior mini-open approach. Femoral osteoplasty can be observed (white arrow). (B) Arthroscopic dry view through the anterior mini-open approach, showing the final view of the procedure. Note that there is no bone bump on the head neck junction (white arrow) or femoroacetabular impingement. (C) Final view of the procedure before releasing the traction, in which the scope introduced through the mini-open approach shows in detail the reconstruction of the superior labrum. (D) Final view of the procedure once the traction has been released, in which the scope introduced through the mini-open approach shows the sealing effect (white arrow) achieved by the reconstructed labrum over the femoral head. Arthroscopy Techniques 2016 5, e1015-e1022DOI: (10.1016/j.eats.2016.05.003) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions