Arthroscopic Labral Reconstruction Is Superior to Segmental Resection for Irreparable Labral Tears in the Hip

Abstract

Background: The acetabular labrum is an important structure that plays a significant role in proper biomechanical function of the hip joint. When the labrum is significantly deficient, arthroscopic reconstruction could provide a potential solution for the nonfunctional labrum. Purpose: To compare the clinical outcomes of arthroscopic labral reconstruction (RECON) with those of arthroscopic segmental labral resection (RESEC) in patients with femoroacetabular impingement (FAI) of the hip. Study Design: Cohort study; Level of evidence, 3. Methods: Between April 2010 and March 2011, all prospectively gathered data for patients with FAI who underwent arthroscopic acetabular labral reconstruction or segmental resection with a minimum 2-year follow-up were reviewed. Eleven cases in the RECON group were matched to 22 cases in the RESEC group according to the preoperative Non-Arthritic Hip Score (NAHS) and sex. The patient-reported outcome scores (PROs) used included the NAHS, the Hip Outcome Score (HOS), and the modified Harris Hip Score (mHHS). Statistical analyses were performed to compare the change in PROs in both groups. Results: There was no statistically significant difference between groups regarding the preoperative NAHS (P = .697), any of the other preoperative PROs, or demographic and radiographic data. The mean change in the NAHS was 24.8 ± 16.0 in the RECON group and 12.5 ± 16.0 in the RESEC group. The mean change in the HOS–activities of daily living (HOS-ADL) was 21.7 ± 16.5 in the RECON group and 9.5 ± 15.5 in the RESEC group. Comparison of the amount of change between groups showed greater improvement in the NAHS and HOS-ADL for the RECON group (P = .046 and .045, respectively). There was no statistically significant difference in the mean changes in the rest of the PROs, although there were trends in all in favor of the RECON group. All PROs in both groups showed a statistically significant improvement at follow-up compared with preoperative levels. Conclusion: Arthroscopic labral reconstruction is an effective and safe procedure that provides good short-term clinical outcomes in hips with insufficient and nonfunctional labra in the setting of FAI.