ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #655

 

Primary Hip Arthroscopy with Labral Reconstruction: Is There a Difference Between Autograft and Allograft?

David R. Maldonado, MD, Elmhurst, IL UNITED STATES
Ajay C. Lall, MD, MS, Westmont, IL UNITED STATES
Victor Ortiz, MD, Chicago, IL UNITED STATES
Austin W. Chen, MD, Boulder, CO UNITED STATES
Joseph Laseter, BA, Cleveland, OH UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Chicago, IL, UNITED STATES

FDA Status Not Applicable

Summary

In this small series, no differences were found in clinical outcomes between hamstring allograft and autograft; therefore, they may be considered as comparable graft choices for primary reconstruction.

Abstract

Background

Labral reconstruction has been described as a solution for the irreparable labrum. Initial techniques employed autografts, while more recent procedures have utilized allografts. No study, to our knowledge, has compared graft types.

Purpose

To compare outcomes between patients who underwent primary labral reconstruction with hamstring allograft versus hamstring autograft.

Hypothesis

No significant differences in outcomes will be found between patients who underwent primary labral reconstruction with allograft versus autograft.

Methods

Data was reviewed from September 2010 to March 2015. Inclusion criteria were as follows: primary hip arthroscopy with labral reconstruction using either a hamstring allograft (ALLO) or autograft (AUTO) and preoperative scores for modified Harris Hip Score (mHHS), Non-Arthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, and Visual Analogue Scale (VAS) patient-reported outcome (PROs) measures. Exclusion criteria were previous ipsilateral hip surgery, previous hip conditions, preoperative Tonnis osteoarthritis grade >1, and Worker’s Compensation claims. Significance was set to P = 0.05.

Results

Twenty-nine patients (29 hips) were included (85.3% follow-up). There were 17 ALLO patients (17 hips) and 12 AUTO patients (12 hips). All PROs and VAS demonstrated significant improvements at latest follow-up except for mHHS for the autograft group (p=0.064). PROs comparisons performed between groups at the preoperative and latest follow-up time points showed no significant differences.

Conclusion

Primary arthroscopic hip labral reconstruction yielded improvements in PROs and high patient satisfaction. In this small series, no differences were found in clinical outcomes between hamstring allograft and autograft. Based on these results, hamstring allograft and autograft may be considered comparable graft choices for primary reconstruction. Due to the avoidance of donor site morbidity and the possible increase in patient satisfaction, allografts may be the preferred choice in a surgical setting when they are accessible.

Study Design: Comparative cohort study; Level of Evidence: 3.