Midterm Outcomes After Labral Reconstruction in Revision Versus Primary Hip Arthroscopy: A Propensity-Matched Study

Abstract

Background:

Differences in outcomes between primary and revision hip arthroscopy are well documented; however, specific comparisons between revision and primary labral reconstruction are limited, especially regarding midterm outcomes.

Purpose:

To evaluate whether revision arthroscopic labral reconstruction achieves minimum 5-year patient-reported outcomes (PROs) and survivorship comparable to primary labral reconstruction.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective review was conducted of patients undergoing labral reconstruction between June 2008 and December 2019. Inclusion required a minimum 5-year follow-up for PROs, including the Nonarthritic Hip Score, International Hip Outcome Tool–12, and Hip Outcome Score–Sports Specific Subscale. Exclusion criteria included Tönnis grade >1, preexisting hip conditions, lateral center-edge angle <20°, active workers’ compensation claims, and intraoperative gluteus medius repair. Revision cases (n = 36) were matched 1:1 with primary reconstruction cases (n = 36) based on age, sex, body mass index, lateral center-edge angle, and capsular treatment strategy.

Results:

Preoperatively, the primary reconstruction cohort had greater cartilage damage but higher baseline scores for the Nonarthritic Hip Score, International Hip Outcome Tool–12, and Hip Outcome Score–Sports Specific Subscale (P < .01). At 5-year follow-up, both cohorts showed significant improvements in all PROs (P < .01) with comparable postoperative outcomes and achievement of clinically meaningful thresholds.

Conclusion:

Labral reconstruction during primary and revision hip arthroscopy showed significant, durable clinical improvements over a minimum 5-year follow-up. Midterm outcomes were comparable, highlighting the efficacy of revision reconstruction in appropriately selected patients.