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Primary Arthroscopic Labral Repair in Acetabular Overcoverage: PROMs and Arthroplasty Rates at Midterm Follow-up.
Sanathan Iyer1, Jason Ina1, Louis Kang1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
The American Journal of Sports Medicine
|June 4, 2026
Summary
Acetabular overcoverage (pincer morphology) in hip arthroscopy did not impact patient-reported outcomes compared to controls. However, controls showed a higher rate of conversion to total hip arthroplasty, suggesting overcoverage may be protective.
Area of Science:
- Orthopedic Surgery
- Hip Preservation Surgery
Background:
- Acetabular overcoverage, or pincer morphology, is debated for its role in hip pain and osteoarthritis.
- This study investigates its impact on clinical outcomes after hip arthroscopic labral repair.
Purpose of the Study:
- To compare minimum 5-year clinical outcomes of hip arthroscopic labral repair in patients with acetabular overcoverage (lateral center edge angle [LCEA] ≥40°) versus nondysplastic controls (LCEA 25°-40°).
Main Methods:
- Retrospective cohort study (Level 3 evidence) comparing 55 patients with pincer morphology to 110 matched controls.
- Analyzed patient-reported outcome measures (PROMs), reoperations, and conversion to total hip arthroplasty (THA).
Main Results:
- No significant differences in PROMs were observed between pincer morphology and control groups at an average 8-year follow-up.
- Pincer patients had a significantly lower rate of conversion to THA (7%) compared to controls (19%).
- Residual acetabular overcoverage post-surgery did not negatively affect PROMs.
Conclusions:
- Hip arthroscopic labral repair in patients with acetabular overcoverage yields comparable outcomes to nondysplastic hips.
- Acetabular overcoverage may have a chondroprotective effect, reducing the need for THA.