• Arthroscopy · Feb 2019

    Controlled Clinical Trial

    Arthroscopic Reconstruction of the Irreparable Acetabular Labrum: A Match-controlled Study.

    • Sivashankar Chandrasekaran, Nader Darwish, Brian H Mu, Danil A Rybalko, Itay Perets, Carlos Suarez-Ahedo, Edwin O Chaharbakhshi, Ajay C Lall, and Benjamin G Domb.
    • Melbourne Orthopaedic and Trauma Institute, Melbourne, Australia.
    • Arthroscopy. 2019 Feb 1; 35 (2): 480-488.

    PurposeTo report clinical outcomes of arthroscopic labral reconstruction in the hip at minimum 2-year follow-up in comparison to a pair-matched labral repair group.MethodsPatients were included in this study if they underwent labral reconstruction during hip arthroscopy and had minimum 2-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 5 years, sex, body mass index within 5, 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 2 years postoperatively. International Hip Outcome Tool and patient satisfaction were also collected at latest follow-up.ResultsThirty-four reconstruction patients were matched to 68 repair patients. There were no significant differences in age (P = .941), sex (P > .999), body mass index (P = .935), or any other demographics between groups. A statistically significant increase was seen in PROs for both the reconstruction group (Modified Harris Hip Score, P = .002; Hip Outcome Score - Sports Subscale, P<.001; Non-arthritic Hip Score, P<.001) and the repair group (Modified Harris Hip Score, P<.001; Hip Outcome Score - Sports Subscale, P < .001; Non-arthritic Hip Score, P<.001) at minimum 2-year follow-up. Significant decrease was shown for VAS for both groups (reconstruction VAS, P<.001; repair, P<.001) at minimum 2-year follow-up. There were no significant differences in rates of postoperative complications (P>.999), secondary arthroscopy (P>.999), or conversion to total hip arthroplasty (P = .728) between groups.ConclusionsArthroscopic labral reconstruction is associated with significant improvement in PROs and a low incidence of secondary surgery within 2-year follow-up. Improvements in PROs, VAS, patient satisfaction, and incidence of secondary procedures were comparable to a match control treated with labral repair. Although there were no differences shown in the 2 groups with respect to complication rate, secondary arthroscopy, or conversion to total hip arthroplasty, the study was not powered to compare these outcome parameters. Based on this evidence, either labral repair or reconstruction may be selected depending upon the clinical scenario.Level Of EvidenceLevel III; retrospective comparative study.Copyright © 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…