Summary

This study evaluates minimum 5-year patient-reported outcome scores (PROs) in patients who underwent primary SLR with hamstring graft, in the setting of femoroacetabular impingement syndrome (FAIS) and irreparable labral tears,

Abstract

Background

Comparable short-term outcomes have been obtained using hamstring allograft versus autograft following primary segmental labral reconstruction (SLR). Mid-term results have not yet been determined.

Purpose

1) To evaluate minimum 5-year patient-reported outcome scores (PROs) in patients who underwent primary SLR with hamstring graft, in the setting of femoroacetabular impingement syndrome (FAIS) and irreparable labral tears, and 2) to compare the outcomes of hamstring autograft vs. allograft in a subanalysis using propensity-matched groups.

Study Design: Retrospective Comparative Therapeutic Trial; Level of evidence, 3.

Methods

Prospectively collected data were retrospectively reviewed for patients who underwent primary hip arthroscopy from September 2010 to November 2015. Patients were included if they underwent SLR using hamstring autograft or allograft and had preoperative and minimum 5-year PROs. Exclusion criteria were previous ipsilateral hip surgery/conditions, dysplasia, or Tönnis grade > 1. Patients with autograft SLR were propensity-matched 1:1 based on age, gender, and body mass index (BMI) to patients who underwent SLR using hamstring allograft. The minimal clinically important difference (MCID), and patient acceptable symptomatic state (PASS) were calculated.

Results

Overall, 48 hips were eligible to be included in this study, and 41 hips (85.4%) had minimum 5-year follow-up reporting significant improvement in all PROs. Fifteen of the 41 included patients underwent a SLR with a hamstring autograft and were matched to 15 patients with labral reconstruction using allograft hamstring. Groups were similar for gender (P >.999), age (P = .775), and BMI (P = .486). The average follow-up time was 80.8 ± 25.5 and 66.1 ± 8.3 months (P = .223) for the autograft and the allograft groups, respectively. Baseline PROs, preoperative radiographic measurements, surgical findings and intra-operative procedures were similar. The groups achieved significant and comparable improvement for all PROs (P < .0001), satisfaction (P = .187), and rate of achieving the MCID and PASS.

Conclusions

At minimum 5-year follow-up, patients who underwent primary arthroscopic SLR, in the context of FAIS and irreparable labra, reported significant improvement and comparable postoperative scores for all PROs, patient satisfaction, MCID, and PASS using either autograft or allograft hamstrings.