Orthopaedic Session II
AB121. SOH24AB_042. Labral repair, reconstruction and augmentation improve postoperative outcomes in patients with irreparable or hypoplastic labra: a systematic review
Jansen Johnson1,2, Prushoth Vivekanantha3, Benjamin Blackman3, Dan Cohen1,2,4, Nicole Simunovic1,2, Olufemi Ayeni1,2
1Division of Orthopaedic Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada;
2Department of Surgery, McMaster University Medical Centre, Hamilton, Ontario, Canada;
3Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada;
4Faculty of Education & Health Services, School of Medicine, University of Limerick, Garraun, Castletroy, Co. Limerick, Ireland
Background: Irreparable and hypoplastic labra of the hip pose a challenge for orthopaedic surgeons. This paper aims to review the outcomes of arthroscopic surgical options in treating these labra.
Methods: Three online databases (PubMed, MEDLINE, EMBASE) were searched from inception to June 27, 2023. Data pertaining to labral classification, surgical method, radiographic findings, and clinical outcomes were recorded. The quality of included studies was assessed by the Methodological Index for Non-Randomized Studies (MINORS) criteria.
Results: Seven case series, eleven retrospective cohort studies, and two prospective cohort studies were included for analysis. Studies were divided into an irreparable labral group comprising 1,002 patients and a hypoplastic labral group comprising 935 patients. Treatments included repair, augmentation, or reconstruction. In the irreparable group, 12 studies recorded improvement of modified Harris Hip Score (mHHS) with preoperative scores ranging from 50.3–67.3 and postoperative scores from 76.2–95.0. The rate of conversion to total hip arthroplasty (THA) and rate of revision arthroscopy were 6.6% and 5.9%, respectively. In the hypoplastic group, two studies that focused on repair noted no statistical difference in mHHS for repair in hypoplastic vs. non-hypoplastic labrum. One study noted that labral repair in non-hypoplastic labra showed superior mHHS compared to hypoplastic labra (P<0.001).
Conclusions: Treatment of irreparable labra with reconstruction or augmentation results in improved patient reported outcome measures (PROMs). For the hypoplastic labrum, primary repair results in improvement in PROMs. Future comparative studies focusing on hypoplastic labra alone, rather than irreparable labral tears are needed to properly assess patient outcomes and guide surgical indications.
Keywords: Arthroscopy; hip; hypoplastic; irreparable; labral
Acknowledgments
Funding: None.
Conflicts of Interest: The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/map-24-ab121
Cite this abstract as: Johnson J, Vivekanantha P, Blackman B, Cohen D, Simunovic N, Ayeni O. AB121. SOH24AB_042. Labral repair, reconstruction and augmentation improve postoperative outcomes in patients with irreparable or hypoplastic labra: a systematic review. Mesentery Peritoneum 2024;8:AB121.
