Comparative Outcomes of Circumferential Versus Segmental Labral Reconstruction in Hip Arthroscopy: A Systematic Review and Meta-analysis

Abstract

Background:

Labral reconstruction has become an essential technique for treating irreparable acetabular labral pathology. While both segmental and circumferential reconstruction techniques are utilized, it remains unclear whether one provides superior clinical outcomes.

Purpose:

To compare patient-reported outcomes, complications, and reoperation rates between segmental and circumferential labral reconstruction.

Study Design:

Meta-analysis.

Methods:

A systematic review of the PubMed, Embase, and Scopus databases was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on February 2, 2025. Studies were included if they reported clinical outcomes after arthroscopic hip labral reconstruction using either segmental or circumferential techniques. Data were extracted on patient characteristics, surgical details, patient-reported outcome measures, complications, revision arthroscopy, and conversion to total hip arthroplasty (THA). Meta-analyses were performed using random-effects models, and heterogeneity was assessed using the I² statistic.

Results:

A total of 28 studies consisting of 1817 hips were included, with 1086 undergoing segmental and 731 undergoing circumferential reconstruction. Patient characteristics were similar between groups, except for a lower proportion of women in the segmental cohort than circumferential cohort (44.6% vs 73.2%; P < .001). Both techniques resulted in significant improvements in all patient-reported outcomes, including the Harris Hip Score, Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports, International Hip Outcome Tool–12 score, Short Form–12 score, and visual analog scale pain score, with no significant differences between groups (all P > .05). Complication rates and revision rates were comparable (P = .05 and P = .06, respectively). However, circumferential reconstruction was associated with a significantly lower conversion to THA compared with segmental reconstruction (P = .01).

Conclusion:

Both segmental and circumferential labral reconstruction techniques provide significant and comparable improvements in functional outcomes and pain. Circumferential reconstruction was associated with a lower pooled rate of conversion to THA; however, causality cannot be inferred given the heterogeneity, nonrandomized design, and differences in follow-up duration between studies.