2023 ISAKOS Biennial Congress Paper
Primary Acetabular Labral Reconstruction In Adolescents, In the Rare Scenario of Irreparable Labral Tears, Resulted In Comparable Improvement, Clinical Benefit, and Revision Surgeries Rate to a Primary Labral Repair Benchmark Group
Benjamin G. Domb, MD, Des Plaines, Illinois UNITED STATES
David R. Maldonado, MD, Houston, TX UNITED STATES
Michael Lee, BA, Milwaukee, Wisconsin UNITED STATES
Benjamin Saks, MD, Exeter, New Hampshire UNITED STATES
Andrew Jimenez, MD, Chicago, Illinois UNITED STATES
Jade S Owens, BS, Chicago, IL UNITED STATES
American Hip Institute Research Foundation, Chicago, IL, UNITED STATES
FDA Status Cleared
Summary
This study reports a benchmark minimum 2-year follow-up patient-reported outcome scores (PROs) and clinical benefit on adolescents following primary labral reconstruction to a propensity-matched (PM) control labral repair group in the primary scenario.
Abstract
Purpose
To benchmark minimum 2-year follow-up patient-reported outcome scores (PROs) and clinical benefit on adolescents following primary labral reconstruction to a propensity-matched (PM) control labral repair group in the primary scenario.
Methods
Data were prospectively collected and retrospectively reviewed on adolescent patients who underwent primary hip arthroscopy between November 2008 and June 2019. Patients were included if they underwent labral reconstruction and had baseline and minimum 2-year follow-up PROs. Patients were excluded if they were unwilling to participate, had Tönnis grade >1, or acetabular dysplasia. The PROs of the primary labral reconstruction study group were compared against a PM benchmark primary labral repair control group based on age at time of surgery, sex, and body mass index in a 1:4 ratio. The minimal clinical important difference (MCID), and the revision surgery rates were reported and compared. A threshold P value of 0.05 was used to determine statistical significance.
Results
Thirteen hips (13 patients) that underwent primary labral reconstruction were included. The mean age was 18.8 years and 38.5% of patients were males. All primary labral reconstruction patients were PM to a control group of 52 hips (49 patients). The improvement (delta value) at minimum 2-year follow-up was comparable between the PM groups for all PROs with high satisfaction (P = 0.284). The control repair group (P = 0.048) experienced significantly lower pain scores using the Visual Analog Scale (VAS) for pain at minimum 2-year follow-up. Rates for MCID achievement and revision surgeries were comparable between the two groups.
Conclusion
In the context of irreparable labral tears, primary labral reconstruction in adolescents demonstrated significant improvement and high patient satisfaction at a minimum 2-year follow-up that was comparable to a benchmarked PM primary labral repair control group. Further, the clinical benefit, and the rate of secondary surgeries were also comparable. However, the improvement for the VAS for pain favored the labral repair group.
Level of Evidence: Level III, retrospective comparative study.