2019 ISAKOS Biennial Congress ePoster #648
Arthroscopic Reconstruction of the Irreparable Acetabular Labrum: A Match-Controlled Study
Sivashankar Chandrasekaran, MBBS, FRACS, St Kilda East, Victoria AUSTRALIA
Nader Darwish, BS, Chicago, IL UNITED STATES
Brian H. Mu, BA, Chicago, IL UNITED STATES
Danil A. Rybalko, MD, Chicago, IL UNITED STATES
Itay Perets, MD, Jerusalem ISRAEL
Carlos E. Suarez-Ahedo, MD, Mexico City MEXICO
Edwin O. Chaharbakhshi, BS, Chicago, IL UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES
American Hip Institute, Chicago, IL, UNITED STATES
FDA Status Not Applicable
Summary
Arthroscopic labral reconstruction is associated with significant improvement in PROs, VAS, patient satisfaction, and a low incidence of secondary procedures at two-year follow-up which is comparable to a match control group treated with labral repair.
Abstract
Purpose
To report clinical outcomes of arthroscopic labral reconstruction in the hip at minimum two-year follow-up in comparison to a pair-matched labral repair group.
Methods
Patients were included in this study if underwent labral reconstruction during hip arthroscopy and had minimum two-year follow-up data available. Exclusion criteria were active workers’ compensation claims or previous ipsilateral hip surgery or conditions. Reconstruction patients were matched 1:2 to patients that underwent arthroscopic labral repair but otherwise met all inclusion and exclusion criteria. Matching criteria were age within five years, sex, body mass index (BMI) within five, same capsular treatment, and whether there was chondral damage of Outerbridge grade II or greater. Three patient-reported outcome (PRO) measures and visual analog scale (VAS) for pain were recorded preoperatively and at a minimum of two years postoperatively. International Hip Outcome Tool (iHOT-12) and patient satisfaction were also collected at latest follow-up.
Results
Thirty four reconstruction patients were matched to 68 repair patients. There were no significant differences in age (p = 0.941), sex (p >0.999), BMI (p = 0.935) or any other demographics between groups. Statistically significant increase was seen in PROs for both the reconstruction group (mHHS p = 0.002, HOT-SS p <0.001), NAHS p <0.001) and the repair group (mHHS p <0.001, HOT-SS p <0.001), NAHS p <0.001) at minimum two-year follow-up. Significant decrease was shown for VAS for both groups (reconstruction VAS p <0.001, repair VAS p <0.001) at minimum two-year follow-up. There were no significant differences in rates of postoperative complications (p >0.999), secondary arthroscopy (p >0.999), or conversion to THA (p = 0.728) between groups.
Conclusion
Arthroscopic labral reconstruction is associated with significant improvement in PROs and a low incidence of secondary surgery within two-year follow-up. Improvements in PROs, VAS, patient satisfaction, and incidence of secondary procedures were comparable to a match control treated with labral repair.
Level of Evidence: III retrospective comparative study