No Difference in Pain Levels and Functional Outcomes After Primary Hip Arthroscopy With Labral Repair Versus Labral Augmentation at Minimum 1-Year Follow-Up

Abstract

Purpose

To retrospectively compare the 1-year clinical outcomes of patients undergoing primary hip arthroscopy with labral repair (LR) versus labral augmentation (LA) for femoroacetabular impingement.

Methods

In this single-surgeon cohort study, we performed a retrospective review of prospectively collected data from patients who underwent primary hip arthroscopy with LR or LA between 2019 and 2022. LA was performed by the addition of an iliotibial band allograft to the repair construct. Indications for LA included a hypotrophic labrum, an everted labrum, or labral ossification. A survey of patient-reported outcome measures (PROMs) was completed at a minimum of 1 year postoperatively. PROMs included the visual analog scale pain score; University of California, Los Angeles Activity Scale score; modified Harris Hip Score; Hip Outcome Score–Sports-Specific Subscale; and Single Assessment Numeric Evaluation. The minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) for each PROM were compared between groups.

Results

A total of 99 patients (99 hips) were included in the final analysis (64 LR and 35 LA patients). No differences were found between the LR and LA groups in terms of demographic characteristics. There was a significantly longer time to follow-up in the LR group (26.1 ± 8.7 months in LR group vs 20.2 ± 7.9 months in LA group, P = .001). There were no significant differences between the LR and LA groups in terms of postoperative PROMs including the visual analog scale pain score (2.3 ± 2.4 vs 3.0 ± 2.7, P = .23); University of California, Los Angeles score (7.8 ± 2.3 vs 7.5 ± 2.6, P = .48); modified Harris Hip Score (77.3 ± 15.3 vs 73.8 ± 16.6, P = .30); Hip Outcome Score–Sports-Specific Subscale (79.0 ± 22.8 vs 69.2 ± 31.8, P = .08); or Single Assessment Numeric Evaluation score (84.8 ± 18.8 vs 77.0 ± 26.1, P = .10). No differences were identified between groups in terms of achieving the MCID, PASS, or SCB for the PROMs assessed. By the final follow-up, 2 patients (3.1%) in the LR group and 0 patients in the LA group underwent revision hip arthroscopy.

Conclusions

At 1-year follow-up, there were no differences in patient-reported outcomes in young active patients undergoing hip arthroscopy with LR versus LA. There were no significant differences in the sex-based subgroup analysis between LR and LA in terms of all postoperative PROMs and in achieving the MCID, PASS, or SCB for the PROMs assessed.

Level of Evidence

Level III, retrospective comparative series.