Patients Undergoing Revision Hip Arthroscopy With Labral Reconstruction or Augmentation Demonstrate Favorable Patient Reported Outcomes: A Systematic Review

Michael S Lee; Scott Fong; Amy Y Lee; Mackenzie Norman; Ronak J Mahatme; Nicholas Pettinelli; Nancy Park; Jack Gagné; Stephen M Gillinov; Wasif Islam; Andrew E Jimenez

doi:10.1016/j.arthro.2023.11.027

Patients Undergoing Revision Hip Arthroscopy With Labral Reconstruction or Augmentation Demonstrate Favorable Patient Reported Outcomes: A Systematic Review

Arthroscopy. 2023 Dec 27:S0749-8063(23)00956-8. doi: 10.1016/j.arthro.2023.11.027. Online ahead of print.

Authors

Affiliations

¹ Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
² Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.
³ Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, U.S.A.
⁴ University of Connecticut School of Medicine, Farmington, Connecticut, U.S.A.
⁵ Kansas City University College of Osteopathic, Kansas City, Missouri, U.S.A.
⁶ Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, U.S.A.. Electronic address: andrew.jimenez@yale.edu.

PMID: 38154532
DOI: 10.1016/j.arthro.2023.11.027

Abstract

Purpose: To review current literature evaluating patient-reported outcomes (PROs) and survivorship in patients undergoing revision hip arthroscopy with labral reconstruction or augmentation.

Methods: A systematic review was performed with the following key words: (revision) AND (hip OR femoroacetabular impingement) AND (arthroscopy OR arthroscopic) AND (reconstruction OR augmentation OR irreparable). PubMed, Cochrane Trials, and Scopus were queried in October 2022 using the criteria established in the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Studies were included if they involved patients undergoing revision hip arthroscopy with labral reconstruction or augmentation and reported preoperative and postoperative PROs at minimum 2-year follow-up. Only original research articles were included. Survivorship was defined as a nonconversion to total hip arthroplasty. Outcomes present in 3 or more studies underwent further statistical analysis with forest plots. Heterogeneity of studies was evaluated using the I² statistic.

Results: Five studies were reviewed, including 359 revision hip arthroscopies (335 with complete follow-up) with a follow-up that ranged from 2.2 to 5.2 years. Four studies reported on outcomes after revision labral reconstruction and 1 study reported on labral augmentation. Two out of 5 included studies evaluated for statistical significance between preoperative and postoperative outcomes. Three out of 5 studies reported a rate of at least 70% for achieving minimal clinically important difference in at least 1 PRO. At minimum 2-year follow-up, survivorship ranged from 93.5% to 100%.

Conclusions: Patients that underwent revision hip arthroscopy with labral reconstruction or augmentation demonstrated improvement in PROs with mixed rates of achieving clinical benefit and rates of survivorship at minimum 2-year follow-up ranging from 93.5% to 100%.

Level of evidence: Level IV: systematic review of level III to IV studies.

Publication types

Review