Background: The acetabular labrum is critical to maintenance of hip stability and has been found to play a key role in preservation of the hip fluid seal. For irreparable labral damage, arthroscopic labral reconstruction is an evolving technique that has been shown to decrease hip pain and restore function. Purpose: To provide a comprehensive review of current literature for arthroscopic hip labral reconstruction, with a focus on determining if outcomes differ between autograft or allograft tissue. Study Design: Systematic review and meta-analysis. Methods: PubMed and Scopus online databases were searched with the key terms “hip,”“labrum,”“reconstruction,” and “graft” in varying combinations. Procedures performed, complications, failures, and functional outcome measures were included in this analysis. The inverse variance method was used to calculate pooled estimates and 95% CIs. Results: Eight studies with 537 hips were included. Mean age was 37.4 years (95% CI, 34.5-40.4 years), and mean follow-up time was 29 months (95% CI, 26-33 months). Survivorship after autograft reconstruction ranged from 75.7% to 100%, as compared with 86.3% to 90.0% in the allograft cohort. In the autograft cohort, failures included 0% to 13.2% conversion to total hip arthroplasty and 0% to 11.0% revision hip arthroscopy. Failures in the allograft cohort included 0% to 12.9% total hip arthroplasty conversion, 0% to 10.0% revision arthroscopy, and 0% to 0.8% open revision surgery. Based on 6 studies, the modified Harris Hip Score improved by a mean 29.0 points after labral reconstruction ( P < .0001). Conclusion: Arthroscopic hip labral reconstruction results in clinically significant improvements in patient-reported outcomes. Our analysis indicates that there are no significant differences in outcomes based on graft type alone. A number of factors may determine graft choice, including patient preference, surgeon experience, operative time, morbidity, and cost. Proper patient selection based on age and severity of degenerative joint disease will also optimize outcomes after labral reconstruction.

Background: Previous studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) in individuals 18 years of age and older. Long-term outcome data in the adolescent population, however, are limited. Purpose: To report 10-year outcomes after hip arthroscopy in adolescents with symptomatic FAI. Study Design: Case series; Level of evidence, 4. Methods: Prospectively collected data were analyzed on adolescent patients younger than 18 years of age who had hip arthroscopy between March 2005 and 2009 with a minimum 10-year follow-up. Patients were included if they were diagnosed with symptomatic FAI and an associated labral tear that was treated with repair. Patients were excluded if they had previous hip procedures, acetabular dysplasia (lateral center-edge angle, <20°), avascular necrosis, previous hip fracture or dislocation, or Legg-Calve-Perthes disease, or refused to participate. The primary patient-reported outcome measure was the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale. In addition, the HOS—Sport, modified Harris Hip Score (mHHS), 12-Item Short Form Health Survey (SF-12), and patient satisfaction were collected. Failure was defined as patients having to undergo revision arthroscopy. Results: There were 60 patients (70 hips) who met inclusion criteria and had a 10-year follow-up. The mean age of the cohort was 16 ± 1.2 years, with 21 male and 49 female hips. Seven hips (10%) required revision hip arthroscopy. All revisions occurred in female patients and were associated with global laxity as well as longer duration of symptoms before time of surgery. At a mean follow-up of 12 years (range, 10-14 years), patients who did not undergo revision surgery had significant improvements from preoperatively to postoperatively in HOS-ADL (from 64 to 92; P < .01), HOS–Sport (from 40 to 86; P < .01), mHHS (from 56 to 88; P < .01), and SF-12 Physical Component Summary (from 41 to 54; P < .01). The median patient satisfaction was 10 out of 10 (very satisfied). Conclusion: Hip arthroscopy for FAI with labral repair resulted in excellent patient-reported outcomes and satisfaction at a minimum of 10 years of follow-up. There was a 10% rate of revision surgery, which was associated with global laxity and longer duration of symptoms before surgery, which should be considered in patient selection.

The differences in timing of the components of dynamic knee valgus between women and men may contribute to the increased risk of noncontact anterior cruciate ligament injuries in female athletes. There may be implications for neuromuscular reeducation training in those at risk for anterior cruciate ligament injury so the components of dynamic valgus occur later in the landing phase of jumping.

Purpose of Review Hip arthroscopy is a rapidly growing field due to its significant diagnostic and therapeutic value in the management of numerous hip disorders. Adequate control of postoperative pain in patients undergoing hip arthroscopy continues to be a challenging and evolving area in orthopedics. In the absence of standardized protocols for pain management in these patients, a variety of different approaches have been utilized in an effort to find a regimen that is effective at reducing postoperative pain, narcotic consumption, and cost to the patient and healthcare system. The purpose of this article, therefore, is to provide a comprehensive review of current literature regarding postoperative pain management techniques in patients undergoing hip arthroscopy. Recent Findings Recent literature demonstrates the importance of a multimodal approach to treat postoperative pain in patients undergoing hip arthroscopy. When a peripheral nerve block or intraoperative anesthetic is used in combination with a pre-and postoperative analgesic medication regimen, patients report less pain and postoperative narcotic consumption. Patient-reported pain scores and postoperative opioid use were similar between the different modalities, however, postoperative complications appear to be less in groups receiving intra-articular (IA) injection or local anesthetic infiltration (LAI) compared to peripheral nerve blocks. Summary In summary, we present evidence that intraoperative techniques, such as IA injection or LAI, in conjunction with preand postoperative pain medications, offers an effective multimodal strategy for treating postoperative pain following hip arthroscopy. This topic is of increasing importance due to the need for cost-effective strategies of managing pain and decreasing opioid consumption following hip arthroscopy.