Radiographic and Demographic Factors Can Predict the Need for Primary Labral Reconstruction in Hip Arthroscopic Surgery: A Predictive Model Using 1398 Hips
Authors: Maldonado DR, Chen JW, Walker-Santiago R, Rosinsky PJ, Shapira J, Lall AC, Kyin C, Domb BG
Background
In patients undergoing hip arthroscopy, determining whether the acetabular labrum is repairable or requires reconstruction is a key surgical decision. This study aims to develop a predictive model based on preoperative demographic and radiographic variables to identify patients more likely to need primary labral reconstruction.
Methods
The study retrospectively analyzed 1,398 hips, comparing characteristics of patients undergoing labral repair vs. reconstruction. Predictive factors examined included age, BMI, Tönnis grade, and lateral center-edge angle (LCEA).
Key Findings
- Older age, higher BMI, Tönnis grade 1, and higher LCEA significantly correlated with the need for labral reconstruction.
- These variables can be combined into a preoperative predictive model to assess the likelihood of labral irreparability.
Conclusions
Patient age, BMI, early arthritic changes, and acetabular overcoverage are significant predictors of intraoperative labral reconstruction. This model can support surgical planning and informed consent.
What Does This Mean for Providers?
- Use demographic and radiographic markers to stratify risk for labral reconstruction preoperatively.
- Incorporating this model aids in case planning, patient counseling, and allograft preparation logistics.
- Particularly valuable for patients >40 years, BMI >25, or with early degenerative changes on imaging.