%0 Journal Article
%T In Revision Hip Arthroscopy, Labral Reconstruction Can Address a Deficient Labrum, but Labral Repair Retains Its Role for the Reparable Labrum: A Matched Control Study
%A Benjamin G. Domb
%A Brian H. Mu
%A Danil Rybalko
%A David R. Maldonado
%A Gary Edwards
%A Itay Perets
%A Muriel R. Battaglia
%J The American Journal of Sports Medicine
%@ 1552-3365
%D 2018
%R 10.1177/0363546518809063
%X Revision hip arthroscopy is increasingly common and often addresses acetabular labrum pathology. There is a lack of consensus on indications or outcomes of revision labral repair versus reconstruction. To report clinical outcomes of labral reconstruction during revision hip arthroscopy at minimum 2-year follow-up as compared with pair-matched labral repair during revision hip arthroscopy (control group) and to suggest a decision-making algorithm for labral treatment in revision hip arthroscopy. Cohort study; Level of evidence, 3. Patients who underwent revision hip arthroscopy with labral reconstruction were matched 1:2 with patients who underwent revision arthroscopic labral repair. Patients were matched according to age, sex, and body mass index. Outcome scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score, Hip Outcome Score¨CSport-Specific Subscale, and a visual analog scale for pain, were collected preoperatively and at minimum 2-year follow-up. At latest follow-up, patient satisfaction on a 0-10 scale and the abbreviated International Hip Outcome Tool (iHOT-12) were collected. Complications, subsequent arthroscopies, and conversion to total hip arthroplasty were collected as well. A total of 15 revision labral reconstructions were pair matched to 30 revision labral repairs. The reconstructions had fewer isolated Seldes type I detachments (P = .008) and lower postoperative lateral center-edge angle, but there were otherwise no significant differences in demographics, radiographics, intraoperative findings, or procedures. Both groups demonstrated significant improvements in all outcomes and visual analog scale at minimum 2-year follow-up. The revision repairs trended toward better preoperative scores: mHHS (mean ¡À SD: 59.3 ¡À 16.5 vs 54.2 ¡À 16.0), Non-Arthritic Hip Score (61.0 ¡À 16.7 vs 51.2 ¡À 17.6), Hip Outcome Score¨CSport-Specific Subscale (39.6 ¡À 25.1 vs 30.5 ¡À 22.1), and visual analog scale (5.8 ¡À 1.8 vs 6.2 ¡À 2.2). At follow-up, the revision repair group had significantly higher mHHS (84.1 ¡À 14.8 vs 72.0 ¡À 18.3, P = .043) and iHOT-12 (72.2 ¡À 23.3 vs 49.0 ¡À 27.6, P = .023) scores than the reconstruction group. The magnitudes of pre- to postoperative improvement between the groups were comparable. The groups also had comparable rates of complications: 1 case of numbness in each group (P > .999), subsequent arthroscopies (repair: n = 2, 6.5%; revision: n = 3, 20%; P = .150), and conversion to total hip arthroplasty (1 patient in each group, P > .999). Labral reconstruction safely and effectively treats irreparable labra in
%K revision hip arthroscopy
%K labral repair
%K labral reconstruction
%K clinical outcomes
%U https://journals.sagepub.com/doi/full/10.1177/0363546518809063