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Revision Hip Arthroscopy: Propensity Score-Matched Comparison of Labral Reconstruction Versus Repair With Minimum
Roger Quesada-Jimenez1, Meredith F Cohen1, Krishi Rana1
1American Hip Institute Research Foundation, Chicago, Illinois, USA.
Background:
There is a paucity of literature comparing the midterm outcomes of arthroscopic labral reconstruction and arthroscopic labral repair in the revision setting.
Purpose:
To evaluate the minimum 5-year patient-reported outcomes (PROs) of patients who underwent revision hip arthroscopy, comparing labral reconstruction with labral repair.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A retrospective analysis was performed for patients who underwent revision hip arthroscopy, either labral repair or labral reconstruction, to treat femoroacetabular impingement and labral tears between 2008 and 2019. Patients who underwent reconstruction were matched 1:1 to patients who underwent repair. Included patients had complete preoperative and minimum 5-year follow-up scores for at least one of the following PRO measures: modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score-Sports-Specific Subscale, patient satisfaction, and visual analog scale for pain. Rates of achieving the minimal clinically important difference and patient acceptable symptom state as well as secondary surgery rates were compared between groups.
Results:
A total of 68 patients were included, with 34 patients who underwent labral reconstruction successfully matched to 34 patients who underwent labral repair, controlling for age, body mass index, sex, acetabular Outerbridge grade, and capsular treatment. The reconstruction group had a significantly higher incidence of Seldes type 1 and 2 labral tears (n = 21 [61.8%]) compared to the repair group, which had a higher proportion of Seldes type 1 tears (n = 11 [32.4%]) (both P < .05). Both groups demonstrated a significant improvement in scores from preoperatively to postoperatively (all P < .01) and achieved the minimal clinically important difference and patient acceptable symptom state at similar rates across all PRO measures. There were no significant differences between groups in the rates of revision arthroscopy or conversion to arthroplasty.
Conclusion:
Patients undergoing revision hip arthroscopy with adequate labral treatment, either labral reconstruction or labral repair, can expect favorable and comparable outcomes, reaching clinically relevant thresholds at similar rates, with a low complication rate, at midterm follow-up.