Revision Hip Labral Reconstruction after Primary Repair Demonstrates Inferior Outcomes Compared to Matched Primary Reconstruction at Minimum 2-Year Follow-Up.

Abstract

Purpose: The purpose of this study was to compare minimum 2-year patient-reported outcomes revision arthroscopic labral reconstruction following failed primary labral repair with those of matched primary labral reconstruction cases.

Methods: Data from patients who underwent labral reconstruction between April 2010 and November 2024 were retrospectively reviewed. Inclusion criteria required revision hip arthroscopy with labral reconstruction and a minimum 2-year follow-up for PROs, including the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), patient satisfaction, and visual analog scale for pain (VAS). Exclusion criteria included Tonnis grade >1, pre-existing hip conditions, lateral central edge angle < 20, intraoperative gluteus medius repair, ongoing workers' compensation claims, and patients with microinstability who underwent remplissage or capsular reconstruction. Revision patients (n=75) were matched 1:1 with a benchmark control group of primary reconstruction patients (n=75).

Results: At a minimum 2-year follow-up, both groups demonstrated significant improvement in all PROs (p < 0.001), with comparable rates of improvement (p > 0.05). However, the revision group showed inferior postoperative outcomes across all PROs (p < 0.01) and lower rates of achieving patient acceptable symptom state (PASS) compared to the control group.

Conclusion: Both primary and revision labral reconstructions lead to significant clinical improvement. However, primary reconstruction achieves superior outcomes, with a higher percentage of patients reaching clinically meaningful thresholds.