Purpose

To evaluate outcomes of arthroscopic hip remplissage with folded iliotibial band (ITB) allograft to treat cam over resection

Methods

Patients who underwent arthroscopic ITB hip remplissage from May 2013 to April 2018 were prospectively evaluated. Pre- and post-operative patient reported outcome scores were compared and included SF12 PCS (Physical Health Composite Score), SF12 MCS (Mental Health Composite Score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Modified Harris Hip Score (mHHS), Hip Outcome Score (HOS) (Activities of Daily Living (ADL) and Sport). Post-operative Tegner Activity Scale and patient satisfaction (1 – 10) were also evaluated.

Results

Thirteen patients (2 males, 11 females) with an average age of 39.8 + 9 years underwent arthroscopic hip remplissage with minimum 2 year and mean 3.1 year follow-up (range, 2.1 – 4.1 years). One hundred percent follow-up was achieved. The average number of previous surgeries was 1.38 (range, 1 to 3). One patient underwent total hip arthroplasty (THA) 2 years after remplissage. All 12 patients who did not undergo THA had improved patient reported outcomes after remplissage (SF12 PCS- 36 vs. 42, p = 0.02; SF12 MCS- 45 vs. 51, p = 0.14; mHHS- 45 vs. 66, p < 0.001, MCID = 83%; WOMAC- 42 vs. 28, p < 0.001, HOS ADL- 52 vs. 69, p = 0.003, MCID = 67%; HOS Sport- 27 vs. 46, p = 0.015, MCID = 67%). All improvements met statistical significance, besides the mental component of the SF12 (SF12 MCS). Median post-operative Tegner score was 2.9. Mean post-operative patient satisfaction was 7.1 out of 10 (range, 5-10).

Conclusions

Arthroscopic hip remplissage is a successful salvage treatment option for hip instability caused by previous cam over-resection. Care must be taken during primary surgery not to over resect the cam as patient reported outcomes after remplissage are inferior to those undergoing primary hip arthroscopy.