Summary

Both primary and revision labral reconstruction exhibit significant clinical improvement. However, primary reconstruction yields superior outcomes.

Abstract

Introduction

Although existing literature suggests poorer outcomes for patients undergoing revision hip arthroscopy compared to those undergoing a primary procedure, there is a lack of evidence demonstrating exactly how revision labral reconstructions compare to primary reconstructions. The purpose of this study is to present minimum 2-year patient reported outcomes (PROs) of revision arthroscopic labral reconstruction in the setting of a failed primary hip arthroscopy in comparison to a matched primary reconstruction group. We anticipate that the revision labral reconstruction cohort will show significant improvement in PROs, albeit potentially inferior when compared to the control group.

Methods

Data from patients that had a labral reconstruction performed between April 2010 and November 2021 was retrospectively reviewed. Patients were included if they underwent a revision hip arthroscopy with labral reconstruction, with minimum 2-year follow-up for modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), patient satisfaction, and visual analog scale for pain (VAS). Exclusion criteria were Tonnis grade >1, pre-existing hip conditions, or ongoing workers’ compensation claims. Revision reconstruction patients were matched in a 1:1 ratio to a benchmark control group of primary labral reconstruction patients.

Results

92 hips who underwent revision labral reconstruction were matched 1:1 to 92 hips who underwent primary labral reconstruction. At a minimum of 2-years follow-up, both groups showed significant improvement in all PROs (p<0.001) with comparable rates of improvement in mHHS, NAHS and VAS (p>0.05). Revision reconstruction demonstrated inferior postoperative outcomes in all PROs when compared to the control group (p<0.001) and lower rates of achieving MCID for iHOT-12 and PASS and SCB for all PROs.

Conclusions

Both primary and revision labral reconstruction exhibit significant clinical improvement. However, primary reconstruction yields superior outcomes, with a higher percentage of patients achieving clinically significant thresholds.