AJSM - 2026-04-01 - Journal Article; Comparative Study
Midterm Outcomes After Labral Reconstruction in Revision Versus Primary Hip Arthroscopy: A Propensity-Matched Study.
Kahana-Rojkind AH, Rana K, O'Brien EJ, Quesada-Jimenez R, Kuhns BD, Domb BG
Topics
Key Takeaway
At minimum 5-year follow-up, revision hip arthroscopic labral reconstruction achieved PRO improvements and clinically meaningful threshold attainment comparable to primary labral reconstruction in propensity-matched patients (n=36 per group).
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Summary
This study asked whether revision labral reconstruction achieves midterm PROs and survivorship equivalent to primary reconstruction. Patients undergoing labral reconstruction from 2008–2019 were propensity-matched on age, sex, BMI, lateral center-edge angle, and capsular treatment strategy, with Tönnis >1 and LCEA <20° excluded. Both cohorts demonstrated significant improvement in NAHS, iHOT-12, and HOS-SSS at 5 years (P<.01), with comparable postoperative scores and clinically meaningful threshold achievement despite the primary cohort having greater baseline cartilage damage and higher preoperative PRO scores.
Key Limitation
The small matched sample of 36 pairs from a single surgeon's series limits generalizability and statistical power to detect clinically important differences in failure rates between groups.
Original Abstract
BACKGROUND
Differences in outcomes between primary and revision hip arthroscopy are well documented; however, specific comparisons between revision and primary labral reconstruction are limited, especially regarding midterm outcomes.
PURPOSE
To evaluate whether revision arthroscopic labral reconstruction achieves minimum 5-year patient-reported outcomes (PROs) and survivorship comparable to primary labral reconstruction.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
A retrospective review was conducted of patients undergoing labral reconstruction between June 2008 and December 2019. Inclusion required a minimum 5-year follow-up for PROs, including the Nonarthritic Hip Score, International Hip Outcome Tool-12, and Hip Outcome Score-Sports Specific Subscale. Exclusion criteria included Tönnis grade >1, preexisting hip conditions, lateral center-edge angle <20°, active workers' compensation claims, and intraoperative gluteus medius repair. Revision cases (n = 36) were matched 1:1 with primary reconstruction cases (n = 36) based on age, sex, body mass index, lateral center-edge angle, and capsular treatment strategy.
RESULTS
Preoperatively, the primary reconstruction cohort had greater cartilage damage but higher baseline scores for the Nonarthritic Hip Score, International Hip Outcome Tool-12, and Hip Outcome Score-Sports Specific Subscale ( P < .01). At 5-year follow-up, both cohorts showed significant improvements in all PROs ( P < .01) with comparable postoperative outcomes and achievement of clinically meaningful thresholds.
CONCLUSION
Labral reconstruction during primary and revision hip arthroscopy showed significant, durable clinical improvements over a minimum 5-year follow-up. Midterm outcomes were comparable, highlighting the efficacy of revision reconstruction in appropriately selected patients.