Labral Tear Management in Patients Aged 40 Years and Older Undergoing Primary Hip Arthroscopy: A Propensity-Matched Case-Control Study With Minimum 2-Year Follow-up
Authors: Maldonado DR, Ouyang VW, Owens JS, Jimenez AE, Saks BR, Sabetian PW, Lall AC, Domb BG
DOI: 10.1177/03635465211046915
Background
Patients aged ≥40 years with labral pathology may have age-related degenerative changes that could impact the effectiveness of labral repair versus reconstruction. This study evaluates whether labral reconstruction is a viable alternative to repair in this population.
Methods
Patients ≥40 years old who underwent hip arthroscopy for femoroacetabular impingement syndrome (FAIS) were matched based on baseline demographics and evaluated for outcomes following either labral repair or reconstruction, with a minimum of 2 years of follow-up.
Key Findings
- Both repair and reconstruction resulted in significant improvements in patient-reported outcomes (mHHS, NAHS, HOS-SSS).
- No significant differences were observed between groups in achieving MCID, PASS, MOI, or in secondary surgery rates.
Conclusions
Both labral repair and reconstruction are effective surgical options for older patients with labral pathology, offering comparable outcomes at 2-year follow-up.
What Does This Mean for Providers?
- For patients ≥40 years, labral reconstruction is a valid alternative to repair when the labrum is non-viable, without compromising outcomes.
- The choice between repair and reconstruction should be based on intraoperative tissue quality rather than age alone.
- Surgeons can expect similar rates of clinical improvement and revision regardless of the technique in this age group.