Abstract
Objectives:
The treatment of labral pathology during hip arthroscopy has evolved over the last decade or more. Recently, the use of labral augmentation or reconstruction with allograft for the treatment of irreparable or tissue-deficient labral pathology has demonstrated favorable outcomes. The purpose of this study was to compare the clinical outcomes of patients undergoing hip arthroscopy with labral repair (LR) versus labral augmentation (LA).
Methods:
A prospective, single-surgeon cohort study was performed on all patients undergoing hip arthroscopy with LR or LA between September 2019 and April 2022. For patients with labral deficiency or a hypotrophic labrum, labral augmentation was performed by addition of iliotibial band allograft to a segment of the repair construct. An electronic survey of patient-reported outcome measures (PROMs) was completed by each patient at a minimum of 1-year postoperatively. PROMs included a visual analog scale (VAS) for pain, University of California - Los Angeles (UCLA) Activity Scale, modified Harris Hip Score (mHHS), Hip Outcome Score-Sport (HOS-Sport), and a Single Assessment Numeric Evaluation (SANE).
Results:
Seventy-nine patients were reached for follow-up (52 LR, 27 LA). No differences were found between the LR and LA groups in terms of age at surgery (34 ± 13 vs 38 ± 13 years, p = 0.15), sex (52% vs 74% female, p = 0.09), or body mass index (26 ± 7 vs 24 ± 5 kg/m2, p = 0.22). Due to a more recent adoption of the LA technique to the senior surgeon’s practice, there was a significantly longer time to follow-up in the LR group (LR: 26 ± 8 months, LA: 20 ± 7 months, p < 0.001). There was a significantly higher HOS-Sport (80.7 ± 21 vs 67.9 ± 33, p=0.04) and SANE (86.7 ± 16 vs 74.4 ± 29, p = 0.02) in the LR group. However, there were no significant differences between groups in other postoperative PROMs including VAS (2.1 ± 2.1 vs 3.0 ± 2.8, p = 0.10), UCLA Activity Scale (7.8 ± 2 vs 7.3 ± 3, p = 0.35), and mHHS (78.6 ± 13 vs 72.5 ± 17, p = 0.09).
Conclusions:
Our study identified mixed short-term functional outcomes when comparing the use of labral augmentation to labral repair in a young and active population. With the evolution of hip arthroscopy and advancements in surgical technique, our study does support the cautious use of labral augmentation when indicated. Larger studies are warranted to corroborate these findings.