Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

Maldonado, David R.; Chen, Sarah L.; Yelton, Mitchell J.; Rosinsky, Philip J.; Walker-Santiago, Rafael; Shapira, Jacob; Lall, Ajay C.; Domb, Benjamin G.

doi:10.1177/2325967119900767

Cited by 14 publications

(18 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2,14,14,24 Primary labral reconstruction has become increasingly implemented in the athletic population. 5,25,41 Boykin et al 5 published successful outcomes and excellent RTS rates after arthroscopic labral reconstruction. They found a significant improvement in mHHS and HOS-SSS in their cohort of 21 elite male athletes.…”

Section: Discussionmentioning

confidence: 99%

Return to Sports and Minimum 2-Year Outcomes of Primary Arthroscopic Hip Labral Reconstruction for Irreparable Tears in High-Level Athletes With a Propensity-Matched Benchmarking Against a Labral Repair Control Group

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Labral reconstruction has shown promise for the treatment of irreparable labral tears in high-level athletes. The literature is scarce regarding outcomes and timing of return to sports (RTS) in these patients. Purpose: (1) To report minimum 2-year patient-reported outcome (PRO) scores and RTS characteristics for high-level athletes undergoing primary labral reconstruction for irreparable labral tears and (2) to compare clinical results with a matched control group of athletes undergoing labral repair. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed for high school, college, and professional athletes who underwent a primary arthroscopic labral reconstruction between January 2010 and June 2018. Minimum 2-year PROs were compared for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and Hip Outcome Score–Sport Specific Subscale (HOS-SSS), as well as the visual analog scale (VAS) pain score, patient satisfaction, and RTS. The percentages of patients achieving the Patient Acceptable Symptom State (PASS) and minimal clinically important difference (MCID) for the mHHS (PASS, >74 points; MCID, >8 points) and HOS-SSS (PASS, >75 points; MCID, >6 points) were also recorded. These patients were propensity score matched in a 1:3 ratio to other high-level athletes undergoing labral repair. Results: A total of 17 high-level athletes with primary arthroscopic labral reconstruction were included with a median follow-up time of 37.1 months (95% CI, 37.2-60.3 months). They demonstrated significant improvement from preoperatively to the latest follow-up for mHHS, NAHS, HOS-SSS, and VAS for pain ( P < .05). Further, patients achieved PASS/MCID for mHHS at high rates (PASS, 84.2%; MCID, 68.4%). Athletes were able to return to sport-specific training at a median of 3.33 months (95% CI, 3.07-4.71 months) and RTS at a median of 6.2 months (95% CI, 5.08-11.98 months). Fourteen (82.4%) of reconstructions and 29 (82.8%) of repairs either returned to sport or decided not to do so for reasons unrelated to the hip. PROs, RTS rate, and PASS/MCID rates were similar between the labral reconstruction group and a control labral repair group ( P > .05). Conclusion: Primary arthroscopic labral reconstruction for irreparable labral tears was associated with significant improvement in PROs and high rates of RTS in high-level athletes. These results were comparable with those of a control group of athletes undergoing labral repair.

show abstract

Section: Discussionmentioning

confidence: 99%

Return to Sports and Minimum 2-Year Outcomes of Primary Arthroscopic Hip Labral Reconstruction for Irreparable Tears in High-Level Athletes With a Propensity-Matched Benchmarking Against a Labral Repair Control Group

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Publications reporting on the outcomes of arthroscopic allograft labral reconstruction have continued to increase, with eight new studies having been published in 2020-2021, alone, on the topic [4,10,[12][13][14]16,19,46]. Overall, evidence has shown highly positive patient-reported outcomes, low failure rates, and significant improvements in functional return to sports (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Considering that labral reconstruction is somewhat still in its adolescence, more research is needed to calculate quantifiable trends in the occurrence of this procedure. However, the last few years have shown a noticeable increase in the numbers of studies focusing on labral reconstruction due to technological and evidence-based innovations in surgical techniques and largely promising and positive outcomes data [4][5][6][7][8][9][10][11][12][13][14][15][16]. Six meta-analysis or systematic reviews have been published in the last few years, alone, and point to equivalent or improved results with labral reconstruction compared to repair (Table 1) [7][8][9]11,17,18].…”

Section: Historical Perspectivesmentioning

confidence: 99%

“…Six meta-analysis or systematic reviews have been published in the last few years, alone, and point to equivalent or improved results with labral reconstruction compared to repair (Table 1) [7][8][9]11,17,18]. Likewise, at least 17 studies have been published within the last decade evaluating various outcomes of arthroscopic labral reconstruction using allograft [4,5,9,10,[12][13][14]16,[19][20][21][22][23][24][25][26][27] and autograft [28][29][30][31][32][33][34][35][36] techniques (Table 2). Overall, current evidence has concluded that arthroscopic labral reconstruction of the hip is associated with improved pain and functional status, low rates of complications or need for revision surgery, and rare progression of arthritis.…”

Section: Historical Perspectivesmentioning

confidence: 99%

See 1 more Smart Citation

Allograft Labral Reconstruction of the Hip: Expanding Evidence Supporting Greater Utilization in Hip Arthroscopy

White

Constantinides²

2022

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Purpose of Review The current review investigates outcomes and failure rates associated with arthroscopic circumferential allograft labral reconstruction of the hip, both as a revision and primary procedure in treating femoroacetabular hip impingement and labral-related pathology. Recent Findings Numerous studies within the last decade have demonstrated excellent patient-reported outcomes, high rates of return-to-play in athletes, and low failure rates in patients having undergone arthroscopic circumferential allograft labral reconstruction of the hip. Removal of chronically diseased and injured labral tissue can eliminate a significant pain-generator from the hip joint. Additionally, circumferential reconstruction of the labrum restores the hoop fiber strength and fluid seal akin to what would be seen with native, healthy labral tissue. Recent research has shown that arthroscopic circumferential allograft labral reconstruction may be used not only in the revision setting, but as a primary procedure. Circumferential labral reconstruction should be considered when a surgeon feels that the labrum is irreparable or has failed previous repair. Summary Arthroscopic circumferential allograft labral reconstruction of the hip can be utilized as treatment option not only in revision settings, but also in primary treatment for femoroacetabular impingement and labral pathology

show abstract

“…Primary labral reconstruction has shown favorable outcomes in athletes, but outcomes of labral reconstruction in the revision setting have not been well established and warrant further study. 6,38,61…”

Section: Discussionmentioning

confidence: 99%

Revision Hip Arthroscopy in High-Level Athletes: Minimum 2-Year Outcomes Comparison to a Propensity-Matched Primary Hip Arthroscopy Control Group

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Outcomes of revision hip arthroscopy in the athletic population have not been well established. Purpose: (1) To report clinical outcomes for high-level athletes undergoing revision hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS) or labral tears and (2) to compare these outcomes against a propensity-matched group of high-level athletes undergoing primary hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Data for professional, college, and high school athletes were prospectively collected and retrospectively reviewed between January 2012 and October 2018. Patients were included if they underwent revision or primary hip arthroscopy and had preoperative and minimum 2-year patient-reported outcome (PRO) scores for modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. The findings and outcomes of revision athletes were compared with a propensity-matched control group of high-level athletes undergoing primary hip arthroscopy. Results: A total of 32 hips (29 patients) undergoing revision hip arthroscopy and 92 hips (88 patients) undergoing primary hip arthroscopy were included in our final analysis with a median follow-up time of 29.5 months (95% CI, 27.2-32.1 months) and 36.5 months (95% CI, 33.5-37.7 months), respectively. Athletes undergoing revision surgery showed significant improvement in all recorded PRO measurements and achieved patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) for mHHS at high rates (80.6% and 83.9%, respectively). When compared with a propensity-matched primary control group, patients undergoing revision surgery demonstrated lower preoperative and postoperative scores for mHHS, NAHS, and HOS-SSS, but the magnitude of improvement in functional scores was similar between groups. Athletes undergoing revision surgery achieved PASS for HOS-SSS at lower rates than the control group ( P = .005), and they were less likely to attempt to return to sport compared with the control group (62.5% vs 87.0%; P < .01). Conclusion: Revision hip arthroscopy is a viable treatment option to improve PROs in high-level athletes at minimum 2-year follow-up. The study group showed significant improvement in functional scores and a high rate of successful outcomes. They experienced similar magnitude of improvement as that of a propensity-matched control group; however, they achieved lower postoperative PRO scores and attempted to return to sport at lower rates.

show abstract

Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

Cited by 14 publications

References 47 publications

Return to Sports and Minimum 2-Year Outcomes of Primary Arthroscopic Hip Labral Reconstruction for Irreparable Tears in High-Level Athletes With a Propensity-Matched Benchmarking Against a Labral Repair Control Group

Return to Sports and Minimum 2-Year Outcomes of Primary Arthroscopic Hip Labral Reconstruction for Irreparable Tears in High-Level Athletes With a Propensity-Matched Benchmarking Against a Labral Repair Control Group

Allograft Labral Reconstruction of the Hip: Expanding Evidence Supporting Greater Utilization in Hip Arthroscopy

Revision Hip Arthroscopy in High-Level Athletes: Minimum 2-Year Outcomes Comparison to a Propensity-Matched Primary Hip Arthroscopy Control Group

Contact Info

Product

Resources

About