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Arthroscopic Acetabular Labral Repair in Patients over the Age of 60: A Matched Case-Control Study

      Introduction

      The purpose of this study is to report the results of labral restoration among patients over age 60 compared to a cohort of younger adults.

      Methods

      23 consecutive patients over age 60 undergoing labral repair with minimum one-year follow-up were compared (modified Harris hip Score) to a contemporaneous group of 23 patients age 18-55 matched for gender, degree of chondral damage, and associated FAI or dysplasia.

      Results

      Follow-up averaged 17.5 months (12 - 24 months). The study group consisted of 13 males and 10 females, average age 63 years (61 - 71); with 21 FAI and one dysplasia. 20 had acetabular articular damage (2 grade IV, 12 grade III, 5 grade II, 1 grade I) and 7 had femoral changes (1 grade IV, 6 grade 3). The exactly matched control group averaged 36 years (20 - 54). Study group improvement averaged 21 points (-19 - 46 points) with 20 (87%) improved. The average improvement in the control group was 19 points (-9 - 34) with 20 (87%) improved. There was no statistically significant difference between the two groups and the amount of improvement with statistically (p<0.01) and clinically (>5 points) significant in both. Two study group patients underwent THA at average 10 months with one control group THA at 11 months. All three converted to THA had combined grade IV acetabular and grade III femoral damage. There were no repeat arthroscopies and no complications in either group.

      Conclusion

      Patients over age 60 can benefit from arthroscopic labral repair with improved outcomes, modest rates of conversion to THA, and small risk of complication. Results are comparable to younger adults. Combined bipolar grade IV and grade III articular damage is a harbinger of conversion to THA, regardless of age.