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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 12/2012

01-12-2012 | Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery

Save the Torn Labrum in Hips With Borderline Acetabular Coverage

Authors: Niraj V. Kalore, MD, William A. Jiranek, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2012

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Abstract

Background

Hip arthroscopy for labral tears improves short-term function, but reoperations occur in 5% to 47% of patients. The effect of borderline acetabular coverage on reoperation rate has been debated. Labral repair rather than débridement has been proposed to improve function, but the effect on reoperation rate is unclear.

Questions/Purposes

We determined whether (1) borderline compared to adequate acetabular coverage increased reoperations and (2) labral repair compared to débridement reduced reoperations.

Methods

We retrospectively reviewed 106 patients (mean age, 39 years) who underwent hip arthroscopy for labral tears. Based on radiographs, we classified patients into those with borderline (n = 50) or adequate (n = 56) acetabular coverage. We further divided each group into those with labral débridement or repair: borderline acetabular coverage, n = 25 and 25, respectively; adequate acetabular coverage, n = 39 and 17, respectively. We assessed reoperations in borderline versus adequate acetabular coverage and labral débridement versus repair, modified Harris hip scores (mHHSs), and survival. Minimum followup was 12 months (mean, 33 months; range, 12–65 months).

Results

Twenty-three of 106 patients had reoperations. Reoperation rate was higher with borderline than with adequate acetabular coverage. Reoperation rate was lower with labral repair than with débridement. Survival to reoperation was similar in the four subgroups although there was a tendency for early reoperation in patients with borderline acetabular coverage with débridement. Improvement in mean mHHS was comparable in the four subgroups.

Conclusions

We found borderline acetabular coverage increased reoperation rates. Labral repair reduced the likelihood of reoperation, especially in hips with borderline acetabular coverage. Hip arthroscopy for labral tears was associated with high reoperation rates in hips with borderline acetabular coverage.

Level of Evidence

Level IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
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Metadata
Title
Save the Torn Labrum in Hips With Borderline Acetabular Coverage
Authors
Niraj V. Kalore, MD
William A. Jiranek, MD
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 12/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2499-9

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