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Midterm Outcomes After Labral Reconstruction in Revision Versus Primary Hip Arthroscopy: A Propensity-Matched Study
Ady H Kahana-Rojkind1,2,3, Krishi Rana1, Elizabeth J O'Brien1
1American Hip Institute Research Foundation, Chicago, Illinois, USA.
Background:
Differences in outcomes between primary and revision hip arthroscopy are well documented; however, specific comparisons between revision and primary labral reconstruction are limited, especially regarding midterm outcomes.
Purpose:
To evaluate whether revision arthroscopic labral reconstruction achieves minimum 5-year patient-reported outcomes (PROs) and survivorship comparable to primary labral reconstruction.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A retrospective review was conducted of patients undergoing labral reconstruction between June 2008 and December 2019. Inclusion required a minimum 5-year follow-up for PROs, including the Nonarthritic Hip Score, International Hip Outcome Tool-12, and Hip Outcome Score-Sports Specific Subscale. Exclusion criteria included Tönnis grade >1, preexisting hip conditions, lateral center-edge angle <20°, active workers' compensation claims, and intraoperative gluteus medius repair. Revision cases (n = 36) were matched 1:1 with primary reconstruction cases (n = 36) based on age, sex, body mass index, lateral center-edge angle, and capsular treatment strategy.
Results:
Preoperatively, the primary reconstruction cohort had greater cartilage damage but higher baseline scores for the Nonarthritic Hip Score, International Hip Outcome Tool-12, and Hip Outcome Score-Sports Specific Subscale (P < .01). At 5-year follow-up, both cohorts showed significant improvements in all PROs (P < .01) with comparable postoperative outcomes and achievement of clinically meaningful thresholds.
Conclusion:
Labral reconstruction during primary and revision hip arthroscopy showed significant, durable clinical improvements over a minimum 5-year follow-up. Midterm outcomes were comparable, highlighting the efficacy of revision reconstruction in appropriately selected patients.
