Durable Outcomes After Hip Labral Reconstruction at Minimum 5-Year Follow-Up: A Systematic Review


Purpose: To systematically review and report the mid- to long-term patient-reported outcomes (PROs) after hip labral reconstruction.

Methods: A literature search of the PubMed, Embase, and Cochrane Library databases was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for clinical studies reporting mid- to long-term PROs at minimum 5-year follow-up after arthroscopic hip labral reconstruction. A quality assessment was performed using the Methodological Index of Non-Randomized Studies grading system. Data collection included study characteristics, demographics, indications, radiographic metrics, perioperative findings, surgical technique, baseline and most recent PROs, and subsequent surgeries.

Results: Four studies met inclusion criteria, with 182 hips (age range, 27.9-38.7 years) undergoing labral reconstruction in primary and revision hip surgery with minimum 5-year follow-up. There were three Level III studies and one Level IV study, with an average Methodological Index of Non-Randomized Studies score of 16.6. All studies cited labral tissue characteristics as a factor for surgical indications, including the quality and/or size of the labrum. Three studies performed segmental labral reconstructions, whereas another study used a circumferential technique. Varying grafts were selected, including hamstring autograft/allograft, ligamentum teres autograft, iliotibial band autograft, and tensor fascia lata autograft. All studies demonstrated improved PROs from baseline to most recent follow-up, with 4 studies reporting modified Harris Hip Score values that increased from baseline (range, 58.9-66.8) to most recent follow-up (range, 80.1-86.3). After labral reconstruction, rates of revision arthroscopy ranged from 4.8% to 13.3% and conversion to total hip arthroplasty ranged from 1.6% to 27%.

Conclusions: Improved PROs were observed in all studies at minimum 5-year follow-up, suggesting that labral reconstruction can offer durable results beyond short-term follow-up. Although surgical indications for all studies included labral tissue characteristics, differing graft selection and surgical techniques were used across studies, limiting the ability to determine an optimal treatment approach.

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