The Everted Acetabular Labrum: Outcomes of Surgical Management

Area of Science:

• Orthopedic Surgery
• Hip Arthroscopy
• Sports Medicine

Background:

• An everted acetabular labrum (EL) is a labral variant where the labrum flips to the capsular side of the acetabular rim.
• Iatrogenic EL can occur after poorly executed labral repairs, and native EL has been recently described.
• This study investigates surgical outcomes for native EL in hip joints.

Purpose of the Study:

• To analyze surgical outcomes after labral advancement or reconstruction in native hip joints with everted acetabular labrum (EL).

Main Methods:

• A multicenter retrospective review of prospectively collected data (2013-2023) on primary hip arthroscopic surgeries.
• Everted acetabular labrum (EL) identified arthroscopically as a labrum-femoral head gap.
• Surgical intervention included labral repair, advancement, augmentation, or reconstruction; hip dysplasia cases also underwent osteotomy.
• Patient-reported outcomes (PROs) assessed using iHOT-12 and Nonarthritic Hip Score preoperatively and up to 24 months postoperatively, compared to a 1:2 case-matched control group.

Main Results:

• 111 patients (129 hips) with EL were identified; 96 hips had available PROs.
• The mean age was 30.5 years, with 87% females; 40.6% had deficient acetabular coverage.
• No significant difference in iHOT-12 scores between EL and control groups at 12 or 24 months (P = .18 and .94).
• Patients with EL showed significant improvement in PROs at latest follow-up (P < .001 for iHOT-12 and Nonarthritic Hip Score).

Conclusions:

• Surgical management of native EL, restoring labral seal and correcting pathologies, leads to significant clinical improvement.
• Postoperative outcome scores in EL patients were comparable to those without EL.
• Evidence supports surgical intervention for native everted acetabular labrum (EL).