Labral Base Repair Compared to Circumferential Suture Repair for Acetabular Labral Repair: A Matched-Paired Comparison of Clinical Outcomes

Abstract

The goal of labral repair is to restore the function of the suction seal effect as the labrum makes contact with the femoral head. The benefits of repair versus debridement have been demonstrated but the ideal method of repair has yet to be determined. The purpose of this analysis is to determine if one labral repair technique is superior to another based on clinical outcomes measured by patient reported outcome (PRO) scores. From February 2008 to February 2012, of 1166 hip arthroscopies, 450 were labral repairs. Two pair-matched groups were created based on acetabular labral repair type, age, gender, radiographic findings, workers compensation and microfracture procedure. Data were prospectively collected and retrospectively reviewed. Patient demographics, intraoperative procedures and radiographic findings were compared to assure similar groups. PROs included visual analog scale (VAS), modified Harris hip score (mHHS), non-arthritic hip score (NAHS), hip outcome score – activities of daily living (HOS-ADL), and hip outcome score – sports subscale (HOS-SS). 110 patients met the inclusion criteria for labral base repair and were paired-matched to 110 who had circumferential repair. Average length of follow-up was 2.5 years for both groups. Patient demographics were statistically similar. Radiographic data were similar between the groups with respect to lateral center-edge angle, acetabular inclination, anterior center edge angle, alpha angle, and joint space width. Intraoperative procedures performed aside from labral repair were of similar frequency with respect to capsule repair/release, femoroplasty, and iliopsoas release. All pre-operative PRO scores were statistically similar. Both groups experienced significant improvement in all PRO's. Comparing group postoperative PRO scores, there was no statistical difference in PRO scores at latest follow-up. There was a similar rate of revision and conversion to arthroplasty. Based on two year PROs, there is no difference in outcomes based on the type of repair that is performed.