PMID- 38092279
OWN - NLM
STAT- Publisher
LR  - 20240114
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
DP  - 2023 Dec 12
TI  - Secondary Hip Labral Reconstruction Yields Inferior Minimum 2-Year Functional 
      Outcomes to Primary Reconstruction Despite Comparable Intraoperative Labral 
      Characteristics.
LID - S0749-8063(23)00983-0 [pii]
LID - 10.1016/j.arthro.2023.11.034 [doi]
AB  - PURPOSE: To compare intraoperative labral characteristics and minimum 2-year 
      functional outcomes of allograft labral reconstruction in primary versus revision 
      hip arthroscopy across multiple orthopaedic centers. METHODS: A retrospective 
      multicenter hip arthroscopy registry was queried for patients with completed 
      labral reconstruction surgeries from January 2014 to March 2023 with completed 
      2-year international Hip Outcome Tool-12 (iHOT-12) reports. Age, sex, and major 
      intraoperative variables also were collected. Patients were placed in cohorts 
      based on whether their arthroscopic allograft labral reconstruction was a primary 
      procedure or secondary procedure (reconstruction following failed hip 
      arthroscopy). One-way analysis of variance was performed on continuous variables. 
      chi(2) test was performed on categorical variables. Achievement of minimal 
      clinically important difference (MCID), Patient Acceptable Symptom State (PASS), 
      and Substantial Clinical Benefit (SCB) also was assessed. RESULTS: In total, 77 
      patients met the inclusion and exclusion criteria and had complete information. 
      The primary reconstruction group (n = 50) was significantly older than the 
      secondary reconstruction group (n = 27) (47.5 +/- 10.5 vs 39.1 +/- 8.8 years; P = 
      .001). In both cohorts, most patients had labral bruising, advanced labral 
      degeneration, and/or grade III complexity of labral tearing. There was no 
      difference in any recorded intraoperative findings (P = .160, P = .783, P = .357, 
      respectively). Each cohort experienced significant improvement in iHOT-12 scores 
      (P < .0001). However, patients undergoing secondary labral reconstruction 
      reported inferior iHOT-12 scores (60.1 +/- 29.2 vs 74.8 +/- 27.0; P = .030). Patients 
      undergoing primary reconstruction were more likely to reach MCID, PASS, and 
      nearly normal SCB (92 vs 66.7%, P = .024; 68.0 vs 40.7%, P = .021; 76.0 vs 48.1%, 
      P = .014, respectively). CONCLUSIONS: Primary and secondary allograft labral 
      reconstruction show clinical improvement, but primary reconstruction demonstrates 
      better outcomes and greater percentage of patients reaching MCID, PASS, and 
      nearly normal SCB than reconstruction in the revision setting. LEVEL OF EVIDENCE: 
      Level III, retrospective comparative prognostic case-control study.
CI  - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Yuro, Matthew R
AU  - Yuro MR
AD  - Peachtree Orthopedics, Atlanta, Georgia, U.S.A.
FAU - Kurapatti, Mark
AU  - Kurapatti M
AD  - Peachtree Orthopedics, Atlanta, Georgia, U.S.A.
FAU - Carreira, Dominic S
AU  - Carreira DS
AD  - Peachtree Orthopedics, Atlanta, Georgia, U.S.A.. Electronic address: 
      dcarreira@pocatlanta.com.
FAU - Nho, Shane
AU  - Nho S
AD  - Midwest Orthopedics at Rush, Chicago, Illinois.
FAU - Martin, Robroy
AU  - Martin R
AD  - Duquesne University, Pittsburgh, Pennsylvania, U.S.A.
FAU - Wolff, Andrew B
AU  - Wolff AB
AD  - Washington Orthopaedics & Sports Medicine, Washington, DC, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20231212
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
COIS- Disclosure All authors (M.R.Y., M.K., D.S.C., R.M., S.N., A.B.W.) declare that 
      they have no known competing financial interests or personal relationships that 
      could have appeared to influence the work reported in this paper. Full ICMJE 
      author disclosure forms are available for this article online, as supplementary 
      material.
EDAT- 2023/12/14 00:42
MHDA- 2023/12/14 00:42
CRDT- 2023/12/13 19:28
PHST- 2023/06/04 00:00 [received]
PHST- 2023/11/16 00:00 [revised]
PHST- 2023/11/19 00:00 [accepted]
PHST- 2023/12/14 00:42 [pubmed]
PHST- 2023/12/14 00:42 [medline]
PHST- 2023/12/13 19:28 [entrez]
AID - S0749-8063(23)00983-0 [pii]
AID - 10.1016/j.arthro.2023.11.034 [doi]
PST - aheadofprint
SO  - Arthroscopy. 2023 Dec 12:S0749-8063(23)00983-0. doi: 
      10.1016/j.arthro.2023.11.034.