Both labral refixation, debridement effective for femoroacetabular impingement
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Key takeaways:
- There were no significant differences in patient-reported outcomes between the labral refixation and debridement groups.
- The procedures had similar rates of reoperation and conversion to total hip replacement.
SAN FRANCISCO — Both labral refixation and debridement may be effective treatments for symptomatic femoroacetabular impingement and show durable improvements in outcomes at long-term follow-up, according to results presented here.
“Contrary to the proposed hypothesis, we found that labral refixation and debridement were both effective and had durable improvement in patient-reported outcomes at 10-year follow-up,” Asheesh Bedi, MD, FAAOS, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
To compare the effectiveness of labral refixation vs. labral debridement for symptomatic femoroacetabular impingement, Bedi and colleagues prospectively collected demographics, radiographic information and patient-reported outcome measures among 237 hips enrolled in the Academic Network of Conservational Hip Outcomes Research multicenter cohort. Researchers matched 48 hips in the labral refixation group to 48 hips in the labral debridement group by age within 5 years, sex and surgical approach to perform a matched analysis.
Outcomes measured included modified Harris Hip Score, University of California Los Angeles Activity Scale, SF-12 physical and mental component scores, rate of reoperation and rate of conversion to total hip replacement. Bedi and colleagues also used the minimally clinically important difference criteria of minimal achievement of 8 points improvement and the patient-acceptable symptomatic state score to assess for failure.
Bedi said a comparison of the refixation and debridement groups showed no significant differences in modified Harris Hip Score or SF-12 physical and mental component scores in either the matched or unmatched analysis. In addition, the two groups had no significant differences in rates of reoperation or conversion to total hip replacement.
“Similar rates of revision and conversion to hip replacement were observed in both categories, and both strategies appear to be reasonable based on intraoperative evaluation of the labrum at the time of well-executed corrective surgery,” Bedi concluded.
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Bedi A, et al. Paper 178. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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