Purpose
The purpose of this study was to evaluate the clinical outcomes of a cohort of patients
who underwent labral repair by use of a previously published labral base repair suture
technique for the treatment of acetabular labral tears and pincer-type femoroacetabular
impingement (FAI).
Methods
Patients who received hip arthroscopy for symptomatic intra-articular hip disorders
and underwent the previously described labral base repair technique were included
in the study group. Patients who had Tönnis arthritis grade 2 or greater, had Legg-Calves-Perthes
disease, or underwent simple looped stitch repair were excluded. The patient-reported
outcome scores included the modified Harris Hip Score, the Non-Arthritic Hip Score,
the Hip Outcome Score–Activities of Daily Living, and the Hip Outcome Score–Sport-Specific
Subscale obtained preoperatively and at 2 years' and 3 years' follow-up. Any complications,
revision surgeries, and conversions to total hip arthroplasty were noted.
Results
Of the patients, 54 (82%) were available for follow-up. The mean length of follow-up
for this cohort was 2.4 years (range, 1.7 to 4.1 years). At final follow-up, there
was significant improvement in all 4 patient-reported outcome scores (modified Harris
Hip Score, 63.7 to 89.9; Non-Arthritic Hip Score, 60.9 to 87.9; Hip Outcome Score–Activities
of Daily Living, 66.9 to 91.0; and Hip Outcome Score–Sport-Specific Subscale, 46.5
to 79.2) (P < .0001). A good or excellent result was achieved in 46 patients (85.2%). There was
significant improvement in pain as measured by the change in visual analog scale score
from 6.5 to 2.3 (P < .0001), and the patient satisfaction rating was 8.56 ± 2.01. There were no perioperative
complications. Revision surgery was required in 3 patients (5.6%), and 2 patients
(3.7%) required conversion to total hip arthroplasty.
Conclusions
The clinical results of this labral base repair technique showed favorable clinical
improvements based on 4 patient-reported outcome questionnaires, visual analog scale,
and patient satisfaction. More clinical, biomechanical, and histologic studies are
needed to determine the optimal repair technique.
Level of Evidence
Level IV, therapeutic case series.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Anatomy, histologic features and vascularity of the adult acetabular labrum.Clin Orthop Relat Res. 2001; 283: 232-240
- Strains across the acetabular labrum during hip motion. A cadaveric model.Am J Sports Med. 2011; 39: 92S-102S
- Effect of acetabular labrum tears on hip stability and labral strain in a joint compression model.Am J Sports Med. 2011; 39: 103S-110S
- An in vitro investigation of the acetabular labral seal in hip joint mechanics.J Biomech. 2003; 36: 171-178
- The influence of the acetabular labrum on hip joint cartilage consolidation: A poroelastic finite element model.J Biomech. 2000; 33: 953-960
- Femoroacetabular impingement: A cause for osteoarthritis of the hip.Clin Orthop Relat Res. 2003; 417: 112-120
- Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement.Arthroscopy. 2009; 25: 369-376
- Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players.Am J Sports Med. 2010; 38: 99-104
- Arthroscopic labral repair in the hip: Surgical technique and review of the literature.Arthroscopy. 2005; 21: 1496-1504
- Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement: A prospective randomized study.Arthroscopy. 2013; 29: 46-53
- Labral base refixation in the hip: Rationale and technique for an anatomic approach to labral repair.Arthroscopy. 2010; 26: S81-S89
- Comments on “Labral base refixation in the hip: Rationale and technique for an anatomic approach to labral repair.”.Arthroscopy. 2011; 27: 303-304
- Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: Minimum two-year follow-up.J Bone Joint Surg Br. 2009; 91: 16-23
- The nonarthritic hip score: Reliable and validated.Clin Orthop Relat Res. 2003; 406: 75-83
- Evidence of validity for the hip outcome score in hip arthroscopy.Arthroscopy. 2007; 23: 822-826
- Patient-reported outcome questionnaires for hip arthroscopy: A systematic review of the psychometric evidence.BMC Musculoskelet Disord. 2011; 12: 117
- Labral penetration rate in a consecutive series of 300 hip arthroscopies.Am J Sports Med. 2012; 40: 864-869
- Callaghan J.J. Rosenberg A.G. Rubash H.E. The adult hip. Lippincott Williams & Wilkins, Philadelphia2007
- Arthroscopic management of femoroacetabular impingement in athletes.Am J Sports Med. 2011; 39: 7S-13S
- Outcomes after the arthroscopic treatment of femoroacetabular impingement in a mixed group of high-level athletes.Am J Sports Med. 2011; 39: 14S-19S
- Patient-reported outcome instruments for femoroacetabular impingement and hip labral pathology: A systematic review of the clinimetric evidence.Arthroscopy. 2011; 27: 279-286
- Correlation of magnetic resonance arthrography with revision hip arthroscopy.Clin Orthop Relat Res. 2013; 471: 4006-4011
Article info
Publication history
Accepted:
November 20,
2013
Received:
January 31,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding: B.H. is a salary paid employee of Arthrex and receives royalties for an orthopaedic product/device from Arthrex. B.G.D. receives support from MAKO Surgical and Arthrex.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
