Impact of Acetabular Labral Tear Location on Patient-Reported Outcomes and Conversion to Total Hip Arthroplasty After Hip Arthroscopy With an 8-Year Minimum Follow-up.

Background: Acetabular labral tears are a common cause of hip pain. While larger tear size has been linked to worse outcomes after arthroscopic treatment, the influence of labral tear location remains incompletely understood.

Purpose: To investigate how labral tear location affects functional outcomes, conversion to total hip arthroplasty (THA), and patient satisfaction after arthroscopy.

Study design: Cohort study; Level of evidence, 3.

Methods: Patients who underwent primary hip arthroscopy were retrospectively sent online surveys at a minimum of 8 years after their surgery. Tear location was classified into superior, anterosuperior, and posterosuperior based on intraoperative findings. Outcomes included patient-reported outcome measures, conversion to THA, Patient Acceptable Symptom State improvement, and overall patient satisfaction. Unadjusted and adjusted logistic regression models were performed to identify potential confounding variables.

Results: In total, 138 patients were included with a mean ± SD follow-up time of 11.1 ± 2.5 years. There was no significant difference in all postoperative patient-reported outcome measures across tear locations, although posterosuperior tears demonstrated lower mean outcomes as compared with superior and anterosuperior. Labral tear location was also not found to significantly influence rates of Patient Acceptable Symptom State achievement. Satisfaction was similar among superior, anterosuperior, and posterosuperior tear locations. THA conversion occurred in 20.9% of patients and was not independently associated with tear location after adjusting for confounders. Age was the strongest predictor of THA conversion, and tear size was also significant.

Conclusion: Acetabular labral tear location was not found to be a significant predictor of functional or clinical outcomes after hip arthroscopy. However, while labral tear location was not predictive of conversion to THA, age and tear size were significant predictors of conversion.