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Preliminary Pain and Function After Labral Reconstruction During Femoroacetabular Impingement Surgery

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

Abstract

Background

Labral refixation rather than resection provides better pain relief and function after femoroacetabular impingement (FAI) surgery. When the labrum is absent, degenerated, or is irreparable, reconstruction may provide a favorable biomechanical environment for the hip. However, it is unclear whether labral reconstruction relieves pain and restores function.

Question/Purposes

In patients undergoing FAI surgery with concomitant labral reconstruction, (1) Do they note subjective improvement in pain at latest followup? (2) What is their postoperative activity level? (3) What are the complications, reoperation rates, and reasons for failure?

Methods

We retrospectively reviewed all 19 patients who underwent labral reconstruction in 20 hips at the time of surgical hip dislocation between August 2007 and February 2011. We assessed improvement in pain and function, complications, and subsequent surgery through a chart review and questionnaire. The minimum followup was 12 months (average, 26.4 months; range, 12–56 months).

Results

Three hips in three patients were converted to THA within 36 months of their surgical hip dislocation for continued preoperative pain. Of the 17 hips not undergoing THA, 15 reported subjective improvement in preoperative pain and function. The average UCLA score was 8.5 (range, 5–10). We observed no complications associated with the labral reconstruction itself.

Conclusion

The majority of patients with reconstructed acetabular labra reported improvement in their hip pain and function after surgery. The causes of persistent symptoms and conversion to THA remain uncertain. The data and conclusions of this study are limited secondary to lack of objective outcome measures.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Gregory Boone of Mayo Medical School for his help with this article and Donna Riemersma in the Orthopedic Department Manuscript Office for her help in the submission of this article.

Author information

Authors and Affiliations

  1. Department of Orthopedics, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Justin A. Walker MD, Michael Pagnotto MD, Robert T. Trousdale MD & Rafael J. Sierra MD

Authors
  1. Justin A. Walker MD
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  2. Michael Pagnotto MD
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  3. Robert T. Trousdale MD
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  4. Rafael J. Sierra MD
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Corresponding author

Correspondence to Rafael J. Sierra MD.

Additional information

One or more of the authors receives funding from Biomet Orthopedics (Warsaw, IN, USA) (RJS) and DePuy Orthopaedics (Warsaw, IN, USA), Wright Medical (Arlington, TN, USA), Mako Surgical (Fort Lauderdale, FL, USA), and Ortho Development Corp. (Draper, UT, USA) (RTT).

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.

Appendix A. Study questions

Appendix A. Study questions

You recently underwent an open surgical hip dislocation with reconstruction of your acetabular labrum with either ligamentum teres capitus or fascia lata autograft.

  1. 1.

    Do you currently have pain in your operative hip?

    If NO: Skip to Question #6

    If YES: Continue to Question #2?

  2. 2.

    How often do you have pain in the operative hip? (constant, daily, occasionally, with activity, rarely)

  3. 3.

    How would you describe your pain? (deep, shallow, dull, sharp, electric, burning)

  4. 4.

    How severe is your pain (mild, moderate, severe)?

  5. 5.

    Would you say your pain is more frequently deep, in your groin, or on the side of your hip?

  6. 6.

    How is your hip compared with before surgery? (much better, better, the same, worse, much worse)

  7. 7.

    If you could make the decision again–given how you feel now, and what you know about the recovery from surgery—would you decide to undergo the procedure again?

  8. 8.

    Now, I will ask you about your current activity level. I will read several choices that may describe your current activity level; please tell me which one best describes your current activity level. (See attached UCLA activity score.)

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Walker, J.A., Pagnotto, M., Trousdale, R.T. et al. Preliminary Pain and Function After Labral Reconstruction During Femoroacetabular Impingement Surgery. Clin Orthop Relat Res 470, 3414–3420 (2012). https://doi.org/10.1007/s11999-012-2506-1

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  • DOI: https://doi.org/10.1007/s11999-012-2506-1

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