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Open and Arthroscopic Acetabular Labral Reconstructions Are Associated With Improvements in Hip Patient-Reported
John R Baumann1, Kylee Rucinski1, James L Cook1
1Thompson Laboratory for Regenerative Orthopaedics Hip Preservation Center Missouri Orthopaedic Institute Department of Orthopaedic Surgery University of Missouri Columbia Missouri U.S.A.
Purpose:
To compare initial outcomes for open versus arthroscopic acetabular labral reconstruction (ALR) using fresh meniscus allograft transplantation.
Methods:
With informed consent, patients scheduled to undergo ALR were enrolled into a registry. Patients included in this study underwent fresh meniscus allograft transplantation for irreparable acetabular labrum deficiency with a minimum of 1 year of complete follow-up data. Patients were excluded if they were pregnant, were incarcerated, or underwent previous or concurrent femoral head cartilage repair procedures. Patient-reported outcome measures were collected preoperatively and 3 months, 6 months, and 1 year postoperatively. Fisher's exact and Wilcoxon signed-rank tests were used for statistical analysis, with P < .05 considered statistically significant.
Results:
A total of 32 consecutive patients met inclusion criteria and were analyzed (22 open, 10 arthroscopic). Overall, 22 open labral reconstructions (100%) were deemed successful, and 9 arthroscopic labral reconstructions (90%) were deemed successful. There was no statistically significant difference in initial failure rates. Both cohorts had significant improvements in Hip Disability and Osteoarthritis Outcome for Joint Replacement, Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function, and PROMIS Physical Health from the preoperative to 1-year postoperative timepoints. For the arthroscopic ALR cohort, there was no significant difference in preoperative and postoperative Visual Analog Scale (6.2 vs 4.6) or PROMIS Pain Interference scores (65.5 vs 58.4). Preoperative PROMIS Pain Interference was significantly higher in the arthroscopic cohort compared with the open cohort (65.5 vs 61.7). Three months (4.7 vs 2.8), 6 months (4.1 vs 2.4), and 1 year (4.6 vs 1.9) Visual Analog Scale pain scores were significantly higher for the arthroscopic cohort compared with the open cohort. At 1 year postoperatively, the minimum clinically important difference threshold was reached for Hip Disability and Osteoarthritis Outcome for Joint Replacement in the arthroscopic cohort and for Visual Analog Scale pain score and Hip Disability and Osteoarthritis Outcome for Joint Replacement in the open cohort.
Conclusions:
The results of this study suggest that open and arthroscopic ALRs with fresh meniscus allograft may significantly improve patient-reported outcomes associated with hip function, health, and recovery at 1 year postoperatively. The open cohort, but not the arthroscopic cohort, had significant improvements in pain at 1 year postoperatively.
Level Of Evidence:
Level III, retrospective comparative study.