Marc J Philippon1, Ioanna K Bolia2, Renato Locks2, Karen K Briggs2. 1. Steadman Clinic, Vail, Colorado, U.S.A.; Steadman Philippon Research Institute, Vail, Colorado, U.S.A.. Electronic address: drphilippon@sprivail.org. 2. Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Abstract
PURPOSE: The purpose of this study was to compare the clinical outcomes and patient satisfaction between patients with previous surgeries who underwent hip labral augmentation versus labral reconstruction surgery. METHODS: From 2006 to 2014, all patients with previous labral procedures who underwent subsequent labral augmentation by the senior surgeon were included. Patients with joint space ≤2 mm and lateral center edge angle <20° and who refused to participate in follow-up were excluded. Patients who underwent labral augmentation, preserving macroscopically healthy native labral tissue and adding iliotibial band graft to increase labral volume, were compared with a matching group (1:2) of patients who underwent labral reconstruction where damaged or absent native labral tissue was replaced by the graft. Hip Outcome Score-Activity of Daily Living (HOS-ADL) was the primary outcome measure. Secondary outcomes included the modified Harris Hip Score (mHHS), HOS for Sports (HOS-Sport), Short Form-12, Western Ontario and McMaster Universities Osteoarthritis Index, and patient satisfaction with outcome. Nonparametric statistics were used to compare groups. RESULTS: Thirty-three patients (12 males, 21 females) who underwent labral augmentation (LA group) were compared with 66 (24 males, 42 females) labral reconstruction patients (LR group). The average age was 29 ± 10 years in both groups. Six patients (18%) required revision arthroscopy in the LA group, and 9 patients (14%) in the LR group (P = .563). One patient (3%) in the LA group required a total hip arthroplasty, and 3 patients in the LR group (4.5%) had a total hip arthroplasty (P = .99). Of the remaining 26 patients in the LA group and 53 patients in the LR group, minimum 2-year follow-up was available for 21 (81%) and 51 (96%), respectively. Postoperatively the HOS-ADL, HOS-Sport, mHHS, and Western Ontario and McMaster Universities Osteoarthritis Index were significantly higher in the LA group (P < .05). The percentage of patients who reached minimum clinically important difference was significantly higher in the LA group for HOS-ADL (P = .002) and HOS-Sport (P = .008); however, there was no difference for the mHHS (P = .795). Patient satisfaction was 10 and 8 in the LA group and LR group, respectively (P = .585). CONCLUSIONS: In patients with previous procedures, the labral augmentation technique with preservation of macroscopically healthy native labral fibers resulted in significantly better outcomes compared with the segmental labral reconstruction procedure where damaged or previously removed labrum was replaced by a graft. LEVEL OF EVIDENCE: Level III, comparative case series.
PURPOSE: The purpose of this study was to compare the clinical outcomes and patient satisfaction between patients with previous surgeries who underwent hip labral augmentation versus labral reconstruction surgery. METHODS: From 2006 to 2014, all patients with previous labral procedures who underwent subsequent labral augmentation by the senior surgeon were included. Patients with joint space ≤2 mm and lateral center edge angle <20° and who refused to participate in follow-up were excluded. Patients who underwent labral augmentation, preserving macroscopically healthy native labral tissue and adding iliotibial band graft to increase labral volume, were compared with a matching group (1:2) of patients who underwent labral reconstruction where damaged or absent native labral tissue was replaced by the graft. Hip Outcome Score-Activity of Daily Living (HOS-ADL) was the primary outcome measure. Secondary outcomes included the modified Harris Hip Score (mHHS), HOS for Sports (HOS-Sport), Short Form-12, Western Ontario and McMaster Universities Osteoarthritis Index, and patient satisfaction with outcome. Nonparametric statistics were used to compare groups. RESULTS: Thirty-three patients (12 males, 21 females) who underwent labral augmentation (LA group) were compared with 66 (24 males, 42 females) labral reconstruction patients (LR group). The average age was 29 ± 10 years in both groups. Six patients (18%) required revision arthroscopy in the LA group, and 9 patients (14%) in the LR group (P = .563). One patient (3%) in the LA group required a total hip arthroplasty, and 3 patients in the LR group (4.5%) had a total hip arthroplasty (P = .99). Of the remaining 26 patients in the LA group and 53 patients in the LR group, minimum 2-year follow-up was available for 21 (81%) and 51 (96%), respectively. Postoperatively the HOS-ADL, HOS-Sport, mHHS, and Western Ontario and McMaster Universities Osteoarthritis Index were significantly higher in the LA group (P < .05). The percentage of patients who reached minimum clinically important difference was significantly higher in the LA group for HOS-ADL (P = .002) and HOS-Sport (P = .008); however, there was no difference for the mHHS (P = .795). Patient satisfaction was 10 and 8 in the LA group and LR group, respectively (P = .585). CONCLUSIONS: In patients with previous procedures, the labral augmentation technique with preservation of macroscopically healthy native labral fibers resulted in significantly better outcomes compared with the segmental labral reconstruction procedure where damaged or previously removed labrum was replaced by a graft. LEVEL OF EVIDENCE: Level III, comparative case series.
Authors: Parth Lodhia; Mark O McConkey; Jordan M Leith; David R Maldonado; Matthew J Brick; Benjamin G Domb Journal: Curr Rev Musculoskelet Med Date: 2021-02
Authors: David R Maldonado; Mitchell J Yelton; Philip J Rosinsky; Jacob Shapira; Mitchell B Meghpara; Ajay C Lall; Benjamin G Domb Journal: BMC Musculoskelet Disord Date: 2020-06-23 Impact factor: 2.362
Authors: Payam W Sabetian; Jade S Owens; David R Maldonado; Kara B Miecznikowski; Benjamin R Saks; Andrew E Jimenez; Hari K Ankem; Ajay C Lall; Benjamin G Domb Journal: Arthrosc Tech Date: 2021-09-08
Authors: Marc Tey-Pons; Bruno Capurro; Raúl Torres-Eguia; Fernando Marqués-López; Alfonso Leon-García; Oliver Marín-Peña Journal: J Hip Preserv Surg Date: 2021-06-23
Authors: David R Maldonado; Jeffrey W Chen; Ajay C Lall; Rafael Walker-Santiago; Jacob Shapira; Philip J Rosinsky; Sarah Chen; Benjamin G Domb Journal: Arthrosc Tech Date: 2019-09-21