Abstract:
Purpose
To systematically review and report the mid- to long-term patient reported outcomes
(PROs) following hip labral reconstruction.
Methods
A literature search of the Pubmed, Embase, and Cochrane Library databases was performed
using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
for clinical studies reporting mid- to long-term PROs at minimum five year follow-up
following arthroscopic hip labral reconstruction. A quality assessment was performed
using the Methodological Index of Non-Randomized Studies (MINORS) grading system.
Data collection included study characteristics, demographics, indications, radiographic
metrics, perioperative findings, surgical technique, baseline and most recent PROs,
and subsequent surgeries.
Results
Four studies met inclusion criteria, with 182 hips (age range, 27.9 to 38.7 years)
undergoing labral reconstruction in primary and revision hip surgery with minimum
five year follow-up. There were three level III studies and one level IV study, with
an average MINORS score of 16.6. All studies cited labral tissue characteristics as
a factor for surgical indications, including the quality and/or size of the labrum.
Three studies performed segmental labral reconstructions, while another study utilized
a circumferential technique. Varying grafts were selected, including hamstring autograft/allograft,
ligamentum teres autograft, iliotibial band autograft, and tensor fascia lata autograft.
All studies demonstrated improved PROs from baseline to most recent follow-up, with
four studies reporting modified Harris Hip Score (mHHS) values that increased from
baseline (range, 58.9 to 66.8) to most recent follow-up (range, 80.1 to 86.3). After
labral reconstruction, rates of revision arthroscopy ranged from 4.8% to 13.3% and
conversion to total hip arthroplasty ranged from 1.6% to 27%.
Conclusion
Improved PROs were observed in all studies at minimum 5-year follow-up, suggesting
that labral reconstruction can offer durable results beyond short-term follow-up.
While surgical indications for all studies included labral tissue characteristics,
differing graft selection and surgical techniques were utilized across studies, limiting
the ability to determine an optimal treatment approach.
Keywords
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Article info
Publication history
Accepted:
February 7,
2023
Received in revised form:
February 2,
2023
Received:
November 8,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
This study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. This study was carried out in accordance with relevant regulations of the US Health Insurance Portability and Accountability Act (HIPAA). Details that might disclose the identity of the subjects under study have been omitted. This study was approved by the IRB. (IRB ID: 5276)
This study was performed at the American Hip Institute Research Foundation.
Author Contributions:
Andrew J. Curley, MD – Data collection/analysis and writing of the manuscript.
Saiswarnesh Padmanabhan, BS, BA – Data collection/analysis and writing of the manuscript.
Omkar N. Prabhavalkar, BA – Data collection/analysis and writing of the manuscript.
Paulo A. Perez-Padilla, MD – Data interpretation and revision of the manuscript.
David R. Maldonado, MD – Data interpretation and revision of the manuscript.
Benjamin G. Domb, MD – Data interpretation and revision of the manuscript.
Level of Evidence: Level IV, systematic review of level III and IV studies
Identification
Copyright
© 2023 Published by Elsevier on behalf of the Arthroscopy Association of North America
