Despite an exponential increase in outcome research following labral reconstruction in the primary and revision setting for FAIS, there has been a paucity of studies that compare the techniques.
The purpose of this study is to compare minimum two-year follow-up patient-reported outcome scores (PROs) in patients who underwent primary acetabular circumferential and segmental labral reconstruction for irreparable labral tears and femoroacetabular impingement syndrome (FAIS).
Study Design & Methods
Level of Evidence: III : Retrospective Therapeutic Trial. Data were reviewed from August 2010 to December 2017. Patients with primary labral reconstruction and minimum two-year PROs were included. Circumferential and segmental reconstruction were selected in each case based on the extent of the labral pathology. Exclusion criteria were previous ipsilateral hip surgery/conditions, dysplasia, or Tönnis grade > 1. Patients were propensity-matched 1:1 based on age, gender, and body-mass index. Secondary surgeries were reported. The P -value was set at < 0.05.
One hundred and forty-four hips were eligible, and 17 hips were lost to followup leaving 127 hips (88.2%) for analysis. Eighty hips underwent a segmental reconstruction, and 47 hips underwent a circumferential reconstruction. Forty-seven hips with circumferential reconstruction were matched to 47 hips with segmental reconstruction. The average follow-up and age for the segmental and circumferential groups were 29.0 ± 7.8 and 27.9 ± 7.0 months ( P = .732), and 43.1 ± 9.4 and 44.7 ± 10.2 years ( P = .442) respectively. The segmental and circumferential groups were 48.9% and 51.1% female, respectively. The groups achieved significant and comparable improvement for all PROs, and rates of secondary surgeries. No differences were found for achieving the minimal clinically important difference and the patient acceptable symptomatic state.
At minimum two-year follow-up, patients who underwent primary hip arthroscopy for either
circumferential or segmental labral reconstruction for irreparable labra and FAIS reported significant improvement and similar postoperative scores for all PROs, with no difference in psychometric outcomes and rate of secondary surgeries. A customized approach, using the extent of the irreparable labral tear, seems to be an appropriate strategy.