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Long-term Outcomes and Conversion to Total Hip Arthroplasty Based on Acetabular Labral Tear Size: Minimum 8-Year
Srish S Chenna1, Jeffrey S Mun1, Brandon J Allen1
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Mass General Brigham Integrated Health Care System, Boston, Massachusetts, USA.
Orthopaedic Journal of Sports Medicine
|February 24, 2026
Summary
Large labral tears (LLTs) after hip arthroscopy are linked to worse long-term outcomes and higher conversion rates to total hip arthroplasty (THA). Small labral tears (SLTs) predict better results and lower THA rates.
Area of Science:
- Orthopedic Surgery
- Hip Arthroscopy
- Patient-Reported Outcomes
Background:
- Limited research exists on how labral tear size impacts long-term patient outcomes and total hip arthroplasty (THA) conversion after hip arthroscopy.
- Understanding this relationship is crucial for surgical decision-making and patient counseling.
Purpose of the Study:
- To compare hip arthroscopy survivorship and patient-reported outcomes (PROs) between patients with large labral tears (LLTs) and small labral tears (SLTs).
Main Methods:
- A retrospective cohort study of 154 patients undergoing primary hip arthroscopy for femoroacetabular impingement between 2001 and 2013.
- Patients were stratified into small labral tear (SLT; ≤60°) and large labral tear (LLT; >60°) groups, excluding those with hip dysplasia or advanced osteoarthritis.
- Long-term outcomes were assessed using PRO measures including modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and the International Hip Outcome Tool (iHOT-33).
Main Results:
- Patients with SLTs demonstrated significantly better outcomes on mHHS, HOS-ADL, and iHOT-33 compared to those with LLTs.
- LLT size was an independent predictor of worse long-term outcomes for mHHS and HOS-ADL.
- The conversion rate to THA was substantially higher in the LLT cohort (hazard ratio, 7.92; P < .0001).
Conclusions:
- Large labral tears (LLTs) are associated with significantly higher rates of conversion to total hip arthroplasty (THA) compared to small labral tears (SLTs).
- Small labral tear (SLT) size independently predicts better long-term patient-reported outcomes following hip arthroscopy.
