Labral, capsular repair may reduce conversion to THA after primary hip arthroscopy
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Key takeaways:
- Results showed 23% of hips were converted to arthroplasty after arthroscopy.
- Combined labral and capsular repair was linked to a 3% conversion rate vs. 31% for noncapsular repair and labral debridement.
DENVER — Results presented here showed labral and capsular repair during primary hip arthroscopy may reduce reoperations and conversions to total hip arthroplasty at long-term follow-up.
“Both labral and capsular repair appear to be protective against conversion to total hip arthroplasty, and both are noted to be modifiable risk factors,” Mario Hevesi, MD, PhD, orthopedic surgeon at the Mayo Clinic in Rochester, Minnesota, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting.
Hevesi and colleagues retrospectively analyzed data from 290 primary hip arthroscopies performed between January 1988 and April 2013. Hevesi noted 59% of patients underwent labral repair and 11% underwent capsular repair.
Outcomes included VAS scores, Tegner Activity Scale score, modified Harris Hip Score (mHHS), hip outcome score for activities of daily living (HOS-ADL) and sport subscales (HOS-SS), patient-acceptable symptom state (PASS) scores, reoperation rates and conversion rates to THA at a minimum follow-up of 10 years.
According to Hevesi, mean VAS scores were 2 at rest and 3 in use. In addition, he said mean HOS-ADL and mean HOS-SS scores were 82 and 74, respectively. The mean mHHS in the patient population was 79. Hevesi and colleagues also found PASS scores fell within a range of 51 to 63.
Hevesi said 33% of hips underwent a reoperation and 23% were converted to THA. However, 3% of hips were converted to THA among patients who underwent combined labral and capsular repair compared with 31% of hips that underwent combined noncapsular repair and labral debridement.
“Conversion to total hip arthroplasty was associated with preoperative patient-sided factors outside of our control, such as age, alpha angle and Tönnis grade,” Hevesi said. “But total hip arthroplasty was also associated with modifiable risk factors, such as a labral and capsular repair, [which are] directly in our control. This highlights the importance of restoring native hip anatomy.”
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Hevesi M, et al. Paper 16. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-14, 2024; Denver.
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