Primary and Revision Circumferential Labral Reconstruction for Femoroacetabular Impingement in Athletes: Return to Sport and Technique

Chasteen, Jesse; Polmear, Michael; Salfiti, Catherine; Wolff, Andrew B.

doi:10.1016/j.arthro.2020.04.045

Cited by 31 publications

(27 citation statements)

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“…Subsequently, my clinical experience with this procedure led me to transition to performing only labral reconstruction in the setting of any labral pathology starting in 2013. I fully agree with the premises presented by Scanaliato et al 5 for why this procedure is the most effective procedure to treat labral pathology. As opposed to labral repair, circumferential labral reconstruction allows for complete removal of all damaged, pain-generating tissue; optimal correction of underlying bony impingement; and consistent creation of a graft that appropriately restores the fluid hip seal, 8 improves pressurization and stabilization, and decreases contact pressure.…”

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confidence: 90%

“…In line with my anecdotal experience, hips that undergo labral reconstruction have been shown to have positive outcomes at minimum 2-year follow-up, despite the fact that in many cases, these hips have more damage and a poorer preoperative prognosis, across previously published outcome studies to date [1][2][3] and in this most recent study by Scanaliato et al 5 In this cohort, all hips achieved substantial clinical benefit and exceeded the minimally clinically important difference from preoperatively to postoperatively. Of the 30 hips, 26 (86.7%) returned to play at a median of approximately 6 months.…”

Section: See Related Article On Page 2598supporting

confidence: 80%

“…[8][9][10] Allograft tissue, in particular, allows for accurate and reliable graft length creation and does not rely on native tissue quality. 11,12 The lengthindependent graft management anchor technique described by Scanaliato et al 5 provides another variation for obtaining and creating ideal graft tension and length to uniformly create a perfect seal between the labral graft and the femoral head.…”

Section: See Related Article On Page 2598mentioning

confidence: 99%

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Editorial Commentary: No Longer a Salvage Procedure: Allograft Labral Reconstruction of the Hip Rivals the Results of Labral Repair

White

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: See Related Article On Page 2598supporting

confidence: 90%

Section: See Related Article On Page 2598supporting

confidence: 80%

Section: See Related Article On Page 2598mentioning

confidence: 99%

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Editorial Commentary: No Longer a Salvage Procedure: Allograft Labral Reconstruction of the Hip Rivals the Results of Labral Repair

White

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…2,14,14,24 Primary labral reconstruction has become increasingly implemented in the athletic population. 5,25,41 Boykin et al 5 published successful outcomes and excellent RTS rates after arthroscopic labral reconstruction. They found a significant improvement in mHHS and HOS-SSS in their cohort of 21 elite male athletes.…”

Section: Discussionmentioning

confidence: 99%

Return to Sports and Minimum 2-Year Outcomes of Primary Arthroscopic Hip Labral Reconstruction for Irreparable Tears in High-Level Athletes With a Propensity-Matched Benchmarking Against a Labral Repair Control Group

et al. 2021

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Background: Labral reconstruction has shown promise for the treatment of irreparable labral tears in high-level athletes. The literature is scarce regarding outcomes and timing of return to sports (RTS) in these patients. Purpose: (1) To report minimum 2-year patient-reported outcome (PRO) scores and RTS characteristics for high-level athletes undergoing primary labral reconstruction for irreparable labral tears and (2) to compare clinical results with a matched control group of athletes undergoing labral repair. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed for high school, college, and professional athletes who underwent a primary arthroscopic labral reconstruction between January 2010 and June 2018. Minimum 2-year PROs were compared for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and Hip Outcome Score–Sport Specific Subscale (HOS-SSS), as well as the visual analog scale (VAS) pain score, patient satisfaction, and RTS. The percentages of patients achieving the Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID) for the mHHS (PASS, >74 points; MCID, >8 points) and HOS-SSS (PASS, >75 points; MCID, >6 points) were also recorded. These patients were propensity score matched in a 1:3 ratio to other high-level athletes undergoing labral repair. Results: A total of 17 high-level athletes with primary arthroscopic labral reconstruction were included with a median follow-up time of 37.1 months (95% CI, 37.2-60.3 months). They demonstrated significant improvement from preoperatively to the latest follow-up for mHHS, NAHS, HOS-SSS, and VAS for pain ( P < .05). Further, patients achieved PASS/MCID for mHHS at high rates (PASS, 84.2%; MCID, 68.4%). Athletes were able to return to sport-specific training at a median of 3.33 months (95% CI, 3.07-4.71 months) and RTS at a median of 6.2 months (95% CI, 5.08-11.98 months). Fourteen (82.4%) of reconstructions and 29 (82.8%) of repairs either returned to sport or decided not to do so for reasons unrelated to the hip. PROs, RTS rate, and PASS/MCID rates were similar between the labral reconstruction group and a control labral repair group ( P > .05). Conclusion: Primary arthroscopic labral reconstruction for irreparable labral tears was associated with significant improvement in PROs and high rates of RTS in high-level athletes. These results were comparable with those of a control group of athletes undergoing labral repair.

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“…We have excellent data that bears out this practice pattern. 10,12,13,15 Additionally, this is not our first rodeo in terms of investigating optimal blocks for arthroscopic surgery of the hip. We previously found that standalone psoas blocks were of no benefit relative to general anesthesia, but lumbar plexus blocks were.…”

Section: Authors' Responsementioning

confidence: 99%

The Interface of Surgical and Anesthesiological Postoperative Analgesic Regime: Pericapsular Injection Versus Lumbar Plexus Block: Response

Christensen¹,

Polmear²,

Salfiti³

et al. 2021

Am J Sports Med

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Primary and Revision Circumferential Labral Reconstruction for Femoroacetabular Impingement in Athletes: Return to Sport and Technique

Cited by 31 publications

References 50 publications

Editorial Commentary: No Longer a Salvage Procedure: Allograft Labral Reconstruction of the Hip Rivals the Results of Labral Repair

Editorial Commentary: No Longer a Salvage Procedure: Allograft Labral Reconstruction of the Hip Rivals the Results of Labral Repair

Return to Sports and Minimum 2-Year Outcomes of Primary Arthroscopic Hip Labral Reconstruction for Irreparable Tears in High-Level Athletes With a Propensity-Matched Benchmarking Against a Labral Repair Control Group

The Interface of Surgical and Anesthesiological Postoperative Analgesic Regime: Pericapsular Injection Versus Lumbar Plexus Block: Response

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