EP1.22 Labral Revision Reconstruction in the Hip: Minimum 2-Year Outcomes with a Nested Propensity-Matched Control

Background: Although existing literature suggests poorer outcomes for patients undergoing revision hip arthroscopy compared to those undergoing a primary procedure, there is a lack of evidence demonstrating exactly how revision reconstructions compare to primary reconstructions.

Purpose/Hypothesis: To present minimum 2-year patient reported outcomes (PROs) of revision arthroscopic labral reconstruction in the setting of a failed primary hip arthroscopy in comparison to a matched primary reconstruction group. We anticipate that revision labral reconstruction will show significant improvement in PROs, albeit potentially inferior when compared to the control group.

Study Design: Retrospective Cohort.

Methods: Data from April 2010 to November 2021 were retrospectively reviewed. Patients were included if they underwent a revision hip arthroscopy for labral reconstruction in the setting of irreparable labral tear and femoroacetabular impingement, with minimum 2-year follow-up for modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT), patient satisfaction, and visual analog scale for pain. Exclusion criteria were Tonnis osteoarthritis grade >1, hip conditions prior to the primary surgery, or workers’ compensation claims. Cases were matched with a benchmark control group of primary labral reconstruction. Patient-reported outcomes and rates of achieving clinically relevant thresholds were compared between the two groups.

Results: 92 hips who underwent revision labral reconstruction were 1:1 matched to 92 hips who underwent primary labral reconstruction. At minimum 2-year follow-up both groups showed significant improvement in all PRO (p<0.001) with comparable rates of improvement in mHHS, NAHS and VAS (p>0.05). Revision reconstruction exhibit inferior 2-year outcomes in all PROs when compared to the control group (p<0.001).

Conclusions: Both primary and revision labral reconstruction exhibit significant clinical improvement. However, primary reconstruction yields superior outcomes, with a higher percentage of patients achieving clinically significant thresholds.