Midterm Outcomes After Labral Reconstruction in Revision Versus Primary Hip Arthroscopy: A Propensity-Matched Study
Author(s):Kahana-Rojkind AH, Rana K, O'Brien EJ, Quesada-Jimenez R, Kuhns BD, Domb BG.
DOI Link: 10.1177/03635465261421538
Background
Labral reconstruction is an established option in both primary and revision hip arthroscopy; however, midterm comparative outcomes between these indications remain limited.
Methods
This Level 3 retrospective cohort study evaluated patients undergoing arthroscopic labral reconstruction between 2008 and 2019 with minimum 5-year follow-up. Revision reconstructions were propensity-matched 1:1 with primary reconstructions based on age, sex, BMI, LCEA, and capsular management. Outcomes included NAHS, iHOT-12, and HOS-SSS, as well as achievement of clinically meaningful thresholds and survivorship.
Key Findings
Both primary and revision cohorts demonstrated significant improvement across all PROs at 5 years (P < .01).
Postoperative outcomes were comparable between groups, with no significant differences in final PRO scores or achievement of clinically meaningful thresholds.
Preoperatively, the primary cohort demonstrated higher baseline PROs despite greater cartilage damage.
Midterm survivorship was similar between revision and primary reconstruction groups.
Conclusion
At midterm follow-up, arthroscopic labral reconstruction yields durable and comparable clinical outcomes in both primary and revision settings when patients are appropriately selected.
What Does This Mean for Providers?
Revision labral reconstruction can achieve outcomes equivalent to primary reconstruction at 5-year follow-up. Despite the increased complexity of revision cases, durable improvements and comparable clinical benefit can be expected with appropriate surgical indication and technique. These findings support labral reconstruction as a reliable option even in revision scenarios.