Revision Hip Labral Reconstruction after Primary Repair Demonstrates Inferior Outcomes Compared to Matched Primary Reconstruction at Minimum 2-Year Follow-Up
Authors
Kahana-Rojkind AH, Rana K, Kingham YE, Hapa O, Quesada-Jimenez R, Domb BG
Background
Labral reconstruction is often performed to restore hip function in patients with damage to the acetabular labrum. When a previous labral repair fails, revision surgery may be needed. However, the outcomes of revision procedures versus primary reconstructions are not well established.
Methods
This retrospective study evaluated outcomes of 75 patients who underwent revision arthroscopic labral reconstruction after a failed repair, compared with 75 matched patients who had primary reconstruction. All patients had at least two years of follow-up. Patient-reported outcomes (PROs) included the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), visual analog scale (VAS) for pain, and patient satisfaction. Exclusion criteria included advanced arthritis (Tonnis grade >1), other hip pathologies, prior gluteus medius repair, and workers' compensation claims.
Key Findings
- Both revision and primary groups showed significant improvement in PROs (p < 0.001).
- The extent of improvement was similar between groups (p > 0.05).
- Revision cases had significantly worse postoperative scores across all PROs (p < 0.01).
- Fewer revision patients achieved the Patient Acceptable Symptom State (PASS) threshold.
Conclusion
Although revision labral reconstruction can result in clinical improvement, outcomes are inferior to those achieved with primary reconstruction, especially in terms of function, pain, and overall patient satisfaction.
What Does This Mean For Patients
Patients undergoing revision labral reconstruction after a failed repair can still experience relief and functional gains, but results are not as favorable as those from a well-executed primary reconstruction. This highlights the importance of optimizing the initial surgical approach.