Outcomes After Anatomic Labral Repair With All-Suture Knotless Tensionable Anchors in Primary Hip Arthroscopic Surgery: A Prospective Analysis of 200 Consecutive Patients.
Authors
Maldonado DR, Bruning RE, Nerys-Figueroa J, Domb BG
Background
In hip arthroscopy for femoroacetabular impingement syndrome (FAIS), restoring the labrum’s suction seal is essential. All-suture knotless tensionable anchors offer a newer, less invasive technique for anatomic labral repair, though outcomes data remain limited.
Methods
This prospective case series evaluated 200 consecutive patients (200 hips) who underwent primary hip arthroscopy for FAIS and labral tears between April 2019 and February 2021 using all-suture knotless tensionable anchors with a controlled-tension anatomic repair technique. Exclusions included previous ipsilateral hip conditions, Tönnis grade >1, and workers' compensation. Patient-reported outcomes (PROs) including mHHS, NAHS, HOS-SSS, iHOT-12, VAS for pain, and satisfaction were collected at baseline and at least 2 years postoperatively. Rates of achieving minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement (MOI) were assessed, along with revision and arthroplasty rates.
Key Findings
- All PROs showed significant improvement at minimum 2-year follow-up (p < .05).
- MCID achievement rates were high:
- mHHS: 91.0%
- NAHS: 92.0%
- HOS-SSS: 93.5%
- VAS: 92.5%
- PASS achievement rates:
- mHHS: 80.5%
- NAHS: 73.0%
- HOS-SSS: 77.0%
- MOI achievement:
- NAHS: 74.5%
- HOS-SSS: 76.5%
- 95.5% achieved either the MCID or PASS in at least one metric.
- Revision hip arthroscopy was performed in 4.0% of patients (mean time to revision: 31.4 months).
- Survivorship free of total hip arthroplasty was 97.5%.
Conclusion
Labral repair using all-suture knotless tensionable anchors during primary hip arthroscopy for FAIS results in significant clinical improvement and high patient satisfaction at short-term follow-up. The technique demonstrates high rates of meaningful outcome achievement and low revision rates, supporting it as a safe and effective surgical option.
What Does This Mean For Patients
Patients undergoing hip arthroscopy for FAIS with this innovative suture anchor technique can expect significant improvements in hip pain and function. The minimally invasive approach has shown high success rates and a low need for revision or further surgery within the first two years.