Preliminary Pain and Function After Labral Reconstruction During Femoroacetabular Impingement Surgery

Walker JA, Pagnotto M, Trousdale RT et al. Preliminary pain and function after labral reconstruction during femoroacetabular impingement surgery. Clin Orthop Relat Res. 2012;470(12):3414-20. doi:10.1007/s11999-012-2506-1.

Abstract

Background
Labral refixation rather than resection provides better pain relief and function after femoroacetabular impingement (FAI) surgery. When the labrum is absent, degenerated, or is irreparable, reconstruction may provide a favorable biomechanical environment for the hip. However, it is unclear whether labral reconstruction relieves pain and restores function.

Question/Purposes
In patients undergoing FAI surgery with concomitant labral reconstruction, (1) Do they note subjective improvement in pain at latest followup? (2) What is their postoperative activity level? (3) What are the complications, reoperation rates, and reasons for failure?

Methods
We retrospectively reviewed all 19 patients who underwent labral reconstruction in 20 hips at the time of surgical hip dislocation between August 2007 and February 2011. We assessed improvement in pain and function, complications, and subsequent surgery through a chart review and questionnaire. The minimum followup was 12 months (average, 26.4 months; range, 12–56 months).

Results
Three hips in three patients were converted to THA within 36 months of their surgical hip dislocation for continued preoperative pain. Of the 17 hips not undergoing THA, 15 reported subjective improvement in preoperative pain and function. The average UCLA score was 8.5 (range, 5–10). We observed no complications associated with the labral reconstruction itself.

Conclusion
The majority of patients with reconstructed acetabular labra reported improvement in their hip pain and function after surgery. The causes of persistent symptoms and conversion to THA remain uncertain. The data and conclusions of this study are limited secondary to lack of objective outcome measures.

Level of Evidence
Level IV, therapeutic study.

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