AJSM - 2026-06-30 - Journal Article
Comparative Outcomes of Circumferential Versus Segmental Labral Reconstruction in Hip Arthroscopy: A Systematic Review and Meta-analysis.
Kurapatti M, Yuro M, Tao BS, Ramey MD, Swaminathan S, Chahla J, Parisien RL
Topics
Key Takeaway
Circumferential labral reconstruction was associated with significantly lower conversion to THA compared to segmental reconstruction (P=.01), though functional outcomes were equivalent across 1,817 hips.
Summary Depth
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Summary
This PRISMA-compliant meta-analysis compared segmental (n=1,086) versus circumferential (n=731) arthroscopic labral reconstruction across 28 studies to determine whether technique affects patient-reported outcomes, complications, or THA conversion. Both techniques produced significant improvements in HHS, HOS-ADL, HOS-Sports, iHOT-12, SF-12, and VAS pain with no between-group differences (all P>.05). Circumferential reconstruction demonstrated a significantly lower rate of conversion to THA (P=.01), though complication and revision arthroscopy rates were statistically comparable (P=.05 and P=.06).
Key Limitation
Differential follow-up duration between segmental and circumferential cohorts confounds the THA conversion rate comparison, as longer follow-up in one group would artificially inflate conversion events.
Original Abstract
BACKGROUND
Labral reconstruction has become an essential technique for treating irreparable acetabular labral pathology. While both segmental and circumferential reconstruction techniques are utilized, it remains unclear whether one provides superior clinical outcomes.
PURPOSE
To compare patient-reported outcomes, complications, and reoperation rates between segmental and circumferential labral reconstruction.
STUDY DESIGN
Meta-analysis.
METHODS
A systematic review of the PubMed, Embase, and Scopus databases was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on February 2, 2025. Studies were included if they reported clinical outcomes after arthroscopic hip labral reconstruction using either segmental or circumferential techniques. Data were extracted on patient characteristics, surgical details, patient-reported outcome measures, complications, revision arthroscopy, and conversion to total hip arthroplasty (THA). Meta-analyses were performed using random-effects models, and heterogeneity was assessed using the I 2 statistic.
RESULTS
A total of 28 studies consisting of 1817 hips were included, with 1086 undergoing segmental and 731 undergoing circumferential reconstruction. Patient characteristics were similar between groups, except for a lower proportion of women in the segmental cohort than circumferential cohort (44.6% vs 73.2%; P < .001). Both techniques resulted in significant improvements in all patient-reported outcomes, including the Harris Hip Score, Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports, International Hip Outcome Tool-12 score, Short Form-12 score, and visual analog scale pain score, with no significant differences between groups (all P > .05). Complication rates and revision rates were comparable ( P = .05 and P = .06, respectively). However, circumferential reconstruction was associated with a significantly lower conversion to THA compared with segmental reconstruction ( P = .01).
CONCLUSION
Both segmental and circumferential labral reconstruction techniques provide significant and comparable improvements in functional outcomes and pain. Circumferential reconstruction was associated with a lower pooled rate of conversion to THA; however, causality cannot be inferred given the heterogeneity, nonrandomized design, and differences in follow-up duration between studies.