FP3.9 Five-Year Outcomes After Primary Acetabular Labral Repair with and without Bone Marrow Aspirate Concentrate: A Case-Control Study

Introduction: Preliminary findings in the literature suggest that treatment with bone marrow aspirate concentrate (BMAC) at the time of hip arthroscopy is a potentially viable solution to improve outcomes in patients with cartilage degradation concomitant to acetabular labral tearing; however functional scores to date have not eclipsed 24 months. Therefore, the present study compares minimum five-year outcomes in patients treated with or without BMAC augmentation to address chondral damage during arthroscopic labral repair.

Methods: This is a case-control study analyzing prospectively collected data in patients who underwent acetabular labral repair with concomitant acetabular breakdown between May 2014 and January 2019. Patients were stratified into either the 1) BMAC cohort or the 2) control cohort depending on the presence or absence of BMAC during surgery. Comparisons were made between cohorts with respect to baseline demographics, intraoperative variables, radiographic measurements, and patient-reported outcomes (PROMs) at 3, 6, 12, 24, and 60 months post-repair.

Results: 81 hips were included for analysis: 39 from the BMAC cohort and 42 from the control cohort. At baseline, both groups presented with similar BMI (BMAC: mean=39.0kg/m2 ± SD of 3.9kg/m2 versus no BMAC: 25.3kg/m2 ± 4.4; p=0.856); Tônnis angle (1.4º ± 7.9º vs. 2.6º ± 7.2º; p=0.502), lateral center edge angle (LCEa) (35.5º ± 7.2º vs. 35.7º ± 6.2º; p=0.879); and alpha angle (54.3º ± 14.9º versus 50.3º ± 16.6º; p=0.262); as well as similar adjusted baseline scores according to mHHS (mean=59.8 [95% confidence interval = 56.1 to 68.0] vs. 61.1 [55.6, 66.6]; p=0.760); HOS-ADL (70.8 [64.9, 76.7] vs. 68.5 [63.0, 74.0]; p=0.490); and HOS-SS (40.6 [28.6, 52.6] vs. 33.4 [22.4, 44.4]; p=0.267). By 60 months, treatment with BMAC yielded significantly improved results compared to the control cohort according to mHHS (95.5 [89.6, 100.0] vs. 83.9 [78.4, 89.4]; p=<.001); iHOT-33 (91.5 [82.7, 100.0] vs. 78.3 [70.2, 86.3]; p=0.006); and HOS-SS (87.7 [75.7, 99.7] vs. 71.4 [60.4, 82.4]; p=0.012).

Discussion/Conclusion: This study adds to the growing body of literature that describes the use of BMAC during acetabular labral repair, as it agrees with previous 24-month findings and includes mid-term follow-up to examine how this relationship persists over time.