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Save the Torn Labrum in Hips With Borderline Acetabular Coverage

  • Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Hip arthroscopy for labral tears improves short-term function, but reoperations occur in 5% to 47% of patients. The effect of borderline acetabular coverage on reoperation rate has been debated. Labral repair rather than débridement has been proposed to improve function, but the effect on reoperation rate is unclear.

Questions/Purposes

We determined whether (1) borderline compared to adequate acetabular coverage increased reoperations and (2) labral repair compared to débridement reduced reoperations.

Methods

We retrospectively reviewed 106 patients (mean age, 39 years) who underwent hip arthroscopy for labral tears. Based on radiographs, we classified patients into those with borderline (n = 50) or adequate (n = 56) acetabular coverage. We further divided each group into those with labral débridement or repair: borderline acetabular coverage, n = 25 and 25, respectively; adequate acetabular coverage, n = 39 and 17, respectively. We assessed reoperations in borderline versus adequate acetabular coverage and labral débridement versus repair, modified Harris hip scores (mHHSs), and survival. Minimum followup was 12 months (mean, 33 months; range, 12–65 months).

Results

Twenty-three of 106 patients had reoperations. Reoperation rate was higher with borderline than with adequate acetabular coverage. Reoperation rate was lower with labral repair than with débridement. Survival to reoperation was similar in the four subgroups although there was a tendency for early reoperation in patients with borderline acetabular coverage with débridement. Improvement in mean mHHS was comparable in the four subgroups.

Conclusions

We found borderline acetabular coverage increased reoperation rates. Labral repair reduced the likelihood of reoperation, especially in hips with borderline acetabular coverage. Hip arthroscopy for labral tears was associated with high reoperation rates in hips with borderline acetabular coverage.

Level of Evidence

Level IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Kathleen Bell for her help with maintenance of a prospective database of the senior author’s patients.

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Correspondence to William A. Jiranek MD.

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Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Kalore, N.V., Jiranek, W.A. Save the Torn Labrum in Hips With Borderline Acetabular Coverage. Clin Orthop Relat Res 470, 3406–3413 (2012). https://doi.org/10.1007/s11999-012-2499-9

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  • DOI: https://doi.org/10.1007/s11999-012-2499-9

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