Arthroscopic Primary Labral Reconstruction in the Hip: Minimum 10-Year Outcomes With a Nested Propensity-Matched Control
Author(s):Domb BG, Sikligar D, Schab AR, Quesada-Jimenez R, McCarroll TR, Kahana-Rojkind AH.
DOI Link: 10.1177/03635465251392196
Background
Arthroscopic labral reconstruction has demonstrated favorable short- and midterm outcomes for irreparable labral pathology; however, long-term comparative data versus primary labral repair remain limited.
Methods
This Level 2 cohort study analyzed prospectively collected data from patients undergoing primary arthroscopic labral reconstruction with allograft for femoroacetabular impingement and labral tears. Minimum follow-up was 10 years with available PRO data. Patients were propensity-matched to a control cohort undergoing primary labral repair in a 1:3 ratio based on age, sex, BMI, and acetabular Outerbridge grade. Outcomes included validated PROs, clinically relevant threshold achievement (MCID/PASS/SCB where applicable), secondary arthroscopy, and survivorship.
Key Findings
A total of 22 reconstruction hips were matched to 66 labral repair hips.
Both groups demonstrated significant and durable improvements in all PROs at ≥10 years, with no significant differences in postoperative scores (P > .05).
Key comparisons included:
- Similar overall postoperative PRO outcomes between reconstruction and repair
- Lower SCB achievement for NAHS in the reconstruction group (P < .05)
- Comparable secondary arthroscopy rates (13.6% vs 10.6%; P > .05)
- Similar survivorship rates (90.9% vs 81.8%; P > .05)
Overall long-term durability was maintained in both groups.
Conclusion
Primary labral reconstruction provides durable 10-year outcomes that are comparable to labral repair in appropriately selected patients. While overall functional outcomes and survivorship are similar, labral reconstruction may demonstrate slightly lower rates of achieving higher-order clinical benefit thresholds.
What Does This Mean for Providers?
At long-term follow-up, labral reconstruction is a reliable alternative to repair in cases of irreparable labral tissue, with comparable survivorship and functional outcomes. Subtle differences in attainment of higher clinical benefit thresholds should be considered in surgical decision-making, but overall results support reconstruction as a durable joint-preserving option.