Purpose
To analyze and compare the mid-term outcomes of hip arthroscopy for patients with
and without labral degeneration from multiple orthopaedic centers. The purpose of
this research is to develop an understanding of the impacts of labral degeneration
on patient outcomes following arthroscopic treatment of labral tears.
Methods
A prospective multicenter hip arthroscopy registry was queried for primary surgeries
from January 2014 to October 2017 with completed 2-year International Hip Outcome
Tool-12 (iHOT-12) reports. Patients were placed into cohorts based on the presence
or absence of labral degeneration noted intraoperatively during hip arthroscopy. Degeneration
was defined as yellowing, ossification, or calcification present in at least 50% of
the labrum. Differences in baseline variation between groups were assessed with a
Wilcoxon rank-sum test or χ2 test. Two-year outcomes were assessed with iHOT-12. Multivariate logistic regression
models were fitted while controlling for age, body mass index, sex, and preoperative
iHOT-12 scores to identify significant predictors of achieving the clinically significant
thresholds of minimal clinically important difference, substantial clinical benefit,
and patient-acceptable symptom scale.
Results
In total, 735 patients met inclusion criteria, of whom 613 had complete outcomes information.
Relative to the control group, the labral degeneration group was significantly older
(mean age 44 ± 11 years vs 33 ± 12 years; P < .01). Both groups experienced statistically significant improvement in iHOT-12
scores from baseline to final follow-up (P < .001); however, patients with labral degeneration reported inferior 2-year iHOT-12
scores when compared with patients without degeneration (P < .001). In the logistic regression models, labral degeneration was a significant
negative predictor of achieving iHOT-12 minimal clinically important difference (odds
ratio [OR] 0.47; 95% confidence interval [95% CI] 0.28-0.79), patient acceptable symptom
state (OR 0.50; 95 CI 0.32-0.77), and substantial clinical benefit (OR 0.58; 95% CI
0.37-0.89).
Conclusions
The results of our study conclude that patients with nondegenerative labral tissue
at the time of repair have superior patient-reported outcomes at mid-term follow-up.
The presence of labral degeneration was a negative predictor of achieving clinically
significant thresholds after controlling for patient age, body mass index, sex, and
baseline iHOT-12 scores.
Level of Evidence
III, retrospective comparative prognostic trial.
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Article info
Publication history
Published online: February 27, 2022
Accepted:
February 20,
2022
Received:
September 16,
2021
Footnotes
See commentary on page 2669
The authors report the following potential conflicts of interest or sources of funding: D.S.C. reports consulting fees from Biomet, Linvatec, and DePuy Orthopaedics; and payment for expert testimony from Arthrex, Smith & Nephew, and Wright Medical Technology. A.B.W. reports consulting fees from Arthrex and Stryker. J.J.C. reports grants or contracts from Allegheny Singer Research Institute; consulting fees from Arthrex and Stryker; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Mid-Atlantic Surgical Systems LLC. J.P.S. reports consulting fees from Stryker; and payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing, or educational events from Liberty Surgical. D.K.M. reports royalties or licenses from Smith & Nephew and Zimmer Biomet; and payment for expert testimony from Pacira Pharmaceuticals. ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
