Minimum 2-Year Outcomes Following Arthroscopic Hip Labral Reconstruction in Adolescents and Young Adults

Abstract

Background: Labral repair is generally preferred when facing labral tears. When an irreparable labral tear in the context of femoroacetabular impingement syndrome is present, arthroscopic labral reconstruction has been proven to be a valid option for labral restoration. However, data on this procedure for the adolescent population is scarce. The purpose of the present study was to report minimum 2-year follow-up patient-reported outcome measures (PROMs) on adolescents and young adults following arthroscopic acetabular labral reconstruction. Methods: Data were prospectively collected and retrospectively reviewed on adolescents and young adults who underwent hip arthroscopy between March 2009 and June 2018. Inclusion criteria were labral reconstruction, baseline and minimum 2-year follow-up PROMs. Patients were excluded if they were unwilling to participate in the study, had Tönnis grade > 1, or dysplasia. Results: Twenty-three hips (22 patients) that underwent labral reconstruction were included. Ten hips (10 patients) underwent primary labral reconstruction, and 13 hips (12 patients) underwent revision reconstruction. The mean age was 19.3 years and 56.5% of patients were males. All patients improved significantly at minimum 2 years for all PROMs (P < 0.001) with high satisfaction. Patients in both groups demonstrated improvement for all PROMs, patient satisfaction, and a rate of achieving the minimal clinically important difference. Conclusion: Arthroscopic labral reconstruction in adolescents and young adults demonstrated significant improvement and high patient satisfaction at minimum 2-year follow-up in the setting of irreparable labral tear. Favorable outcomes, high patient satisfaction, and high achievement rate for the minimal clinically important difference were obtained following labral reconstruction in this population the primary and revision scenarios.

Graft Options for Hip Labral Reconstruction

“…Unfortunately, the average defect length or graft length was not reported; however, the Oxford hip score improved from 30 to 36 postoperatively and mean HOS improved from 59.5 to 79.3. Maldonado et al 36 reported outcomes for 28 adolescent hips (27 patients) undergoing reconstruction with semitendinosus allografts with a minimum 2-year follow-up. The authors initially used autografts but switched to allografts to reduce donor site morbidity.…”

5-Year Arthroscopy-Free Survivorship and Outcomes of Adolescents Undergoing Primary Hip Arthroscopy: A Comparison Between Traumatic and Atraumatic Injuries

“…11,30 Adolescents have demonstrated favorable short-, mid-, and long-term outcomes with durable improvements in PROs and low rates of revision. 26,30 Although adolescents undergoing primary hip arthroscopy have demonstrated significant improvement after hip arthroscopy, the mechanism of injury may influence reoperation rates. Ashberg et al 5 reported on adolescents who had acute onset from a discrete event of hip pain and demonstrated significantly higher reoperation rates compared with a matched group of adolescents with a chronic onset of injury.…”

“…11,30 Adolescents have demonstrated favorable short-, mid-, and long-term outcomes with durable improvements in PROs and low rates of revision. 26,30…”