EP1.9 Secondary Hip Labral Reconstruction Yields Inferior Minimum 2-Year Functional Outcomes to Primary Reconstruction Despite Comparable Intraoperative Labral Characteristics

Purpose: To compare intraoperative labral characteristics and minimum 2-year functional outcomes of allograft labral reconstruction in primary versus revision hip arthroscopy across multiple orthopedic centers.

Method: A retrospective multicenter hip arthroscopy registry was queried for patients with completed labral reconstruction surgeries from January 2014 to March 2023 with completed 2-year international Hip Outcome Tool-12 (iHOT-12) reports. Age, sex, and major intraoperative variables were also collected. Patients were placed in cohorts based on whether their arthroscopic allograft labral reconstruction was a primary procedure or secondary procedure (reconstruction following failed hip arthroscopy). One-way ANOVA was performed on continuous variables. Chi-squared test was performed on categorical variables. Achievement of minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and Substantial Clinical Benefit (SCB) was also assessed.

Results: In total, 77 patients met the inclusion and exclusion criteria and had complete information. The primary reconstruction group (n=50) was significantly older than the secondary reconstruction group (n=27) (47.5 ± 10.5 vs 39.1 ± 8.8 years; P = 0.001). In both cohorts, most patients had labral bruising, advanced labral degeneration, and/or grade III complexity of labral tearing. There was no difference in any recorded intraoperative findings (P = 0.160, P = 0.783, P = 0.357, respectively). Each cohort experienced significant improvement in iHOT-12 scores (P < .0001). However, patients undergoing secondary labral reconstruction reported inferior iHOT-12 scores (60.1 ± 29.2 vs 74.8 ± 27.0; P = 0.030). Patients undergoing primary reconstruction were more likely to reach MCID, PASS, and nearly normal SCB (92 vs 66.7%, P = 0.024; 68.0 vs. 40.7%, P = 0.021; 76.0 vs 48.1%, P = 0.014, respectively).

Conclusions: Based on this small, non-randomized, non-matched, retrospective study, allograft labral reconstruction may be considered in the primary as well as revision settings.

Level of Evidence: III, retrospective comparative prognostic case-control study.