TY - JOUR
T1 - Indications and Outcomes of Arthroscopic Labral Reconstruction of the Hip
T2 - A Systematic Review
AU - Trivedi, Nikunj N.
AU - Sivasundaram, Lakshmanan
AU - Su, Charles A.
AU - Knapik, Derrick
AU - Nho, Shane J.
AU - Mather, Richard C.
AU - Salata, Michael J.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: S.J.N. receives research support from AlloSource, Arthrex, Athletico, DJ Orthopaedics, Linvatec, Miomed, Smith & Nephew, Stryker, and Össur. R.C.M. receives research support from Reflexion and Zimmer and receives personal fees from KNG Health Consulting and Stryker. M.J.S. receives personal fees from Stryker. Full ICMJE author disclosure forms are available for this article online, as supplementary material. The authors report the following potential conflicts of interest or sources of funding: S.J.N. receives research support from AlloSource, Arthrex, Athletico, DJ Orthopaedics, Linvatec, Miomed, Smith & Nephew, Stryker, and Össur. R.C.M. receives research support from Reflexion and Zimmer and receives personal fees from KNG Health Consulting and Stryker. M.J.S. receives personal fees from Stryker. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2019 Arthroscopy Association of North America
PY - 2019/7
Y1 - 2019/7
N2 - Purpose: The primary purpose of this investigation was to systematically evaluate the literature for the current indications and outcomes of arthroscopic labral reconstruction of the hip. Our secondary purpose was to evaluate the role of arthroscopic labral reconstruction in the management of reparable labral tears. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using a PRISMA checklist. Studies published between June 2009 and June 2018 that evaluated outcomes after arthroscopic labral reconstruction with a minimum of 1 year of follow-up were included. Results: Eleven studies met the inclusion and exclusion criteria. A total of 373 patients were identified. Of the 11 studies, 9 reported that an irreparable labrum was their indication for reconstruction, with 8 reporting that this was ultimately determined intraoperatively. Substantial variability in surgical technique, graft choice, and concurrent pathology was found. All 11 studies used at least 1 validated functional outcome metric to evaluate surgical outcomes, with all studies reporting improvement greater than the minimal clinically important difference. Donor-site pain was the most common complication, although it was reported in only 2 studies. Reported rates of revision surgery and conversion to arthroplasty were low (range, 0%-9.1% for both). Conclusions: All 11 studies included in this systematic review reported clinically significant functional improvements after arthroscopic labral reconstruction and low rates of complications, revision surgery, and progression of arthritis, although graft types and concomitant procedures confound the results. The most common indication for reconstruction was a deficient labrum on intraoperative evaluation. The 6 studies that evaluated patient satisfaction reported favorable results, with a range of 6.73 to 8.7. Level of Evidence: Level IV, systematic review of Level III and IV studies.
AB - Purpose: The primary purpose of this investigation was to systematically evaluate the literature for the current indications and outcomes of arthroscopic labral reconstruction of the hip. Our secondary purpose was to evaluate the role of arthroscopic labral reconstruction in the management of reparable labral tears. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using a PRISMA checklist. Studies published between June 2009 and June 2018 that evaluated outcomes after arthroscopic labral reconstruction with a minimum of 1 year of follow-up were included. Results: Eleven studies met the inclusion and exclusion criteria. A total of 373 patients were identified. Of the 11 studies, 9 reported that an irreparable labrum was their indication for reconstruction, with 8 reporting that this was ultimately determined intraoperatively. Substantial variability in surgical technique, graft choice, and concurrent pathology was found. All 11 studies used at least 1 validated functional outcome metric to evaluate surgical outcomes, with all studies reporting improvement greater than the minimal clinically important difference. Donor-site pain was the most common complication, although it was reported in only 2 studies. Reported rates of revision surgery and conversion to arthroplasty were low (range, 0%-9.1% for both). Conclusions: All 11 studies included in this systematic review reported clinically significant functional improvements after arthroscopic labral reconstruction and low rates of complications, revision surgery, and progression of arthritis, although graft types and concomitant procedures confound the results. The most common indication for reconstruction was a deficient labrum on intraoperative evaluation. The 6 studies that evaluated patient satisfaction reported favorable results, with a range of 6.73 to 8.7. Level of Evidence: Level IV, systematic review of Level III and IV studies.
UR - http://www.scopus.com/inward/record.url?scp=85068089221&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2019.02.031
DO - 10.1016/j.arthro.2019.02.031
M3 - Review article
C2 - 31272640
AN - SCOPUS:85068089221
SN - 0749-8063
VL - 35
SP - 2175
EP - 2186
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 7
ER -