Bilateral Hip Arthroscopy: Direct Comparison of Primary Acetabular Labral Repair and Primary Acetabular Labral Reconstruction.

Abstract

Directly compare primary acetabular labral repair versus primary acetabular labral reconstruction using a self-controlled cohort study design. Patients who underwent primary labral repair in one hip and primary labral reconstruction using iliotibial band allograft in the other hip by a single surgeon between August 2009 and November 2014 were identified. One patient with inflammatory arthritis was excluded. Patient-reported outcome data included change in Modified Harris Hip Score (MHHS), Lower Extremity Functional Scale (LEFS), average pain using a 10-point visual analog scale (VAS), and patient satisfaction (1: very dissatisfied, 10: very satisfied). Failure was defined as subsequent intra-articular hip surgery. Data were analyzed using McNemar's and Wilcoxon Signed Rank tests. Overall, 29 patients (58 hips) were included in the analysis. There were 23 females and 6 males. The average age at time of surgery was 32.6 years (range: 14.9-51.6 years). Follow-up was obtained from all 29 patients (100%) at a mean of 56 months (range = 27-85 months) postoperative for repaired hips and 40 months (range = 22-61 months) postoperative for reconstructed hips. No labral reconstruction hips failed, and 9 (31%) labral repair hips failed (P < .01). Among those that did not fail treatment, there was no difference in MHHS change (32.2 ± 15.4 vs 29.6 ± 15.4; P = .63), LEFS change (26.6 ± 16.5 vs 23.9 ± 17.8; P = .61), VAS pain change (-3.2 ± 2.4 vs -3.6 ± 2.1; P = .47), or satisfaction (8.6 ± 2.0 vs 8.7 ± 2.4; P = .59) between the repair and reconstruction groups, respectively. In this cohort of patients, hips that underwent primary labral repair were more likely to fail treatment than hips that underwent labral reconstruction (31% vs 0%, respectively). Among hips that did not fail treatment, patient-reported outcome scores were similar between groups. Excellent clinical results can be obtained with both forms of labral-preserving treatment but were more predictably observed with primary labral reconstruction in this cohort. LEVEL OF EVIDENCE: Level III, retrospective comparative study.