Clinical and radiographical results of labral reconstruction

Abstract

Treatment of femoroacetabular impingement (FAI) includes correction of underlying bony deformities. Labrum preservation is recommended whenever possible. In hips, where the labrum is missing or damaged beyond preservation, labral reconstruction is an option to restore labral seal. Between 2008 and 2011, 84 hips underwent treatment for FAI by means of a surgical hip dislocation. In 13 of these hips (11 patients), the severely damaged or missing labrum was reconstructed with ligamentum capitis femoris. Pre- and postoperative radiographic and clinical data were analysed with a mean follow-up of 38 months (range: 19-65 months). Clinical outcome was determined with Oxford hip score (OHS) and overall satisfaction, rest and load pain with a visual analogue scale (VAS; 0-100). Clinical outcome was compared with a control group where labral refixation was performed. Mean OHS improved significantly (P ≤ 0.001) from 29 (SD 8) to 44 (SD 4). Overall satisfaction with the hip increased significantly (P = 0.002) from 44 (SD 35) to 87 (SD 15). Mean VAS for rest pain decreased significantly (P = 0.0004) from 45 (SD 35) to 5 (SD 7) as well as for load pain (P = 0.0007) from 59 (SD 26) to 16 (SD 19). There were no significant differences between the two groups. Reconstruction of the acetabular labrum with ligamentum capitis femoris yields good clinical results. Technical superiority of open labral reconstruction may explain the unexpected, excellent outcome.