Analysis Labral Repair Knotless Suture Anchor: Controlled-Tension Technique Minimum Two-Year Follow-up

Abstract

To report clinical outcomes of arthroscopic labral repair in the hip using knotless anchor technique with minimum 2-year follow-up in the setting of femoroacetabular impingement (FAI) and labral tears. Data was prospectively collected for patients who underwent hip labral repair using a knotless suture anchor. Patients were included if they had minimum 2-year follow-up for modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score- Sport Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12) and visual analog scale for pain (VAS). Patients with dysplasia, Tönnis grade >1, prior history of hip conditions, any previous ipsilateral hip surgery, or workers’ compensation cases were excluded. Proportion of patients who achieved the minimal clinically important difference (MCID) or patient acceptable symptomatic state (PASS) for mHHS, HOS-SSS, and iHOT-12 were also reported. Statistical significance was set at P = 0.05. There were 309 hip arthroscopies that met the inclusion criteria. Patient population consisted of 211 (68.3%) females, and the mean age was 36.2 years (range, 12.8-75.9). Mean preoperative lateral center-edge angle was 31.9° and the mean preoperative alpha angle was 57.1°. In addition to labral repair, 245 (79.3%) patients underwent capsular plication, all patients underwent femoroplasty, and 290 (93.9%) underwent an acetabuloplasty. Mean traction time was 53.5 minutes. At minimum 2-year follow-up favorable mHHS, 86.9 ± 16.2 (P < 0.001), NAHS, 86.1 ± 16.7 (P < 0.001) and HOS-SSS, 74.2 ± 27.3 (P < 0.001) were obtained. Significant decrease was shown for VAS (P < 0.001). The mean patient satisfaction was 8.1. Approximately 78.6% and 82.2% of the patients achieved the MCID and PASS for mHHS and 60.8% and 69.9% met the MCID and PASS for HOS-SSS, respectively. MCID for iHOT-12 was met by 77.3% of patients. At minimum 2-year follow-up, hip arthroscopy in the setting of FAI and labral tears using knotless anchor technology was associated with significant and favorable improvement in several patient-reported outcomes, VAS, and patient satisfaction. Based on this evidence, knotless labral repair seems to be a safe option.