EP1.23 Larger Labral Size Is Associated with Decreased Survivorship Following Primary Hip Arthroscopy in Borderline Hip Dysplasia
TL;DR
Patients with BHD who underwent primary hip arthroscopy with labral repair for FAI showed significant functional improvements regardless of their labral size, however, patients with large labral size had lower survivorship compared to those with a labral size <5mm at mid-term follow-up.
Abstract
Abstract Purpose This study aims to determine the impact of labral size on the mid-term outcomes of patients with borderline hip dysplasia (BHD) who underwent hip arthroscopy as treatment for labral tears and femoroacetabular impingement (FAI). Methods Prospectively collected data were analyzed for patients who underwent primary hip arthroscopy for treatment of FAI with labral repair and capsular plication between June 2011 and March 2020. Patients were included if they presented with BHD defined as lateral center-edge angle (LCEA) between 18°-25°, and had pre- and minimum 5-year post-operative patient-reported outcomes (PROs) including modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), International Hip Outcome Tool (iHOT-12), Hip Outcome Score-Sport Scale (HOS-SSS), and Visual Analog Scale (VAS). Patients with a labral size ≥ 5 mm were allocated in the large labrum group and were propensity matched based on age at surgery, sex, body mass index, and follow-up time to patients with a labral size < 5mm. A multivariate regression was performed to assess predictors of secondary procedures. Results A total of 98 patients were included in this study; 49 patients in the large labrum group and 49 patients in the small labrum cohort. The groups demonstrated significant and comparable improvements across all evaluated PROs at the latest follow-up. Rates of achieving MCID and PASS were similar between the groups. The large labral size cohort had a higher rate of secondary surgeries (28.5% to 8.2%). Multivariable regression confirmed that BHD patients with larger labra with an odd ratio of 2.13, (95% CI 1.16-3.85, p = 0.0137). Conclusion Patients with BHD who underwent primary hip arthroscopy with labral repair for FAI showed significant functional improvements regardless of their labral size. However, patients with large labral size had lower survivorship compared to those with a labrum size <5mm at mid-term follow-up.