Resolution of Hip Microinstability Caused by Everted Labrum Through a Targeted Intraarticular Anchor Repair...

Labral eversion has recently been described as an anatomic variation in a nondysplastic patient with impingement-type hip pain and an otherwise intact labrum that is associated with microinstability.

To compare clinical outcomes after hip arthroscopy between patients with hip microinstability caused by everted labrums and those with femoroacetabular impingement (FAI).

Cohort study; Level of evidence, 3.

This study included patients who underwent surgery at a tertiary hospital center between 2015 and 2022 after failure of nonoperative treatment for at least 6 months. Data-including demographic characteristics, body mass index, visual analog scale (VAS) scores, and preoperative and long-term follow-up Hip Outcome Score (HOS), lateral center-edge angle (LCEA), and upsloping lateral sourcil-were collected from the clinical records. The same surgical team treated all patients, followed the same rehabilitation protocol, and observed them for a minimum of 24 months. Clinical improvement was evaluated using HOS, VAS, and return to sports outcomes. Patients were organized into 2 groups. Group 1 included patients with an intraoperative diagnosis of everted labrum, whereas group 2 served as the control group, consisting of patients with classic FAI associated with labral tears. Statistical analysis was performed using the t test and 95% CI.

A total of 76 patients (n = 88 hips) who underwent hip arthroscopy during the study period were divided into 2 groups. We found a greater presence of upsloping lateral acetabular rim in group 1 (65% vs 11%; P = 4.77 × 10^-7). Group 1 demonstrated a significantly greater LCEA compared with group 2 (37.1° vs 34.6°, respectively; P = .010). The HOS scores were 91.6 and 92.2 (P = .226) and 97.8 and 98.1 (P = .575) in groups 1 and 2, respectively, at 6 and 12 months postoperatively. Furthermore, postoperative VAS scores were not significantly different between the 2 groups (P = .574).

Our study demonstrated that clinical and functional outcomes are not significantly different between patients operated on for an everted labrum with intra-articular anchor placement technique and those operated on for normal labral tears in FAI.These findings suggest that, when appropriately identified and treated with a technique focused on restoring the labral seal, the everted labrum does not negatively affect long-term postoperative results. Recognition and proper management of this anatomic variant are therefore essential in achieving successful surgical outcomes.