Multicenter Outcomes After Revision Hip Arthroscopy: Comparative Analysis of 2-Year Outcomes After Labral Repair Versus Labral Reconstruction

Blake M. Bodendorfer, Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Hip Preservation Center, Rush University Medical Center, Chicago, Illinois, USA.
Thomas D. Alter, Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Hip Preservation Center, Rush University Medical Center, Chicago, Illinois, USA.
Andrew B. Wolff, Hip Preservation and Sports Medicine, Washington Orthopaedics and Sports Medicine, Washington, DC, USA.
Dominic S. Carreira, Peachtree Orthopedics, Atlanta, Georgia, USA.
John J. Cristoforetti, Center for Athletic Hip Injury, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
John P. Salvo, Department of Orthopaedic Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Dean K. Matsuda, DISC Sports and Spine Center, Marina del Rey, California, USA.
Benjamin R. Kivlan, Rangos School of Health Sciences, Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, USA.
Shane J. Nho, Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Hip Preservation Center, Rush University Medical Center, Chicago, Illinois, USA.

Abstract

BACKGROUND: There is a paucity of literature evaluating patient outcomes in patients undergoing revision labral repair and labral reconstruction. PURPOSE: To compare outcomes in patients undergoing revision hip arthroscopy for treatment of labral tears by labral repair or labral reconstruction. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A retrospective review of a prospectively maintained multicenter database of patients undergoing hip arthroscopy was performed. An a priori power analysis determined that a total of 62 patients were required. Patients undergoing revision hip arthroscopy for labral tears with completed 2-year outcome scores were included. Patients undergoing primary hip arthroscopy, labral debridement, concomitant gluteal repair, and patients with hip dysplasia (lateral center-edge angle < 20°) were excluded. Patients were grouped into revision labral repair and labral reconstruction groups. Patient demographics and patient-reported outcomes (PROs) including Hip Outcome Score - Activities of Daily Living, Hip Outcome Score - Sport Subscale, modified Harris Hip Score, international Hip Outcome Tool-12, visual analog scale for pain and satisfaction, and achievement of minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were analyzed. RESULTS: A total of 40 patients underwent revision labral repair and 55 patients underwent labral reconstruction. Patients undergoing revision labral repair were younger (mean age, 30.0 ± 10.7 years vs 34.4 ± 9.7 years; = .048), had lower rates of labral degeneration (25.0% vs 62.7%; = .004), and had lower rates of severe complexity of tears (21.1% vs 66.0%; = .003). However, the labral repair group had higher rates of articular cartilage damage (62.5% vs 33.3%; = .009). There were no differences in any preoperative or 2-year postoperative PROs. Furthermore, no differences were seen in achievement of MCID or PASS in any PRO. CONCLUSION: In this multicenter study on revision hip arthroscopy, patients undergoing revision labral repair were younger and had better labral characteristics but greater cartilage damage compared with patients undergoing labral reconstructions. Despite these differences, patients who underwent labral repair reported similar outcomes to those undergoing labral reconstruction.