Repair or partial excision of the labrum of the acetabulum are the traditional techniques for treating the femoroacetabular impingement syndrome. Reconstruction of the labrum is considered a more advanced and specialised technique, and is indicated in cases where this structure is deficient. In recent years there has been a discussion in the literature about the optimal technique for treating tears of the acetabular labrum.
A recent study in “Journal of Hip Preservation Surgery” set out to analyse the long-term results of the techniques of reconstruction, and of repair or partial excision, of the acetabular labrum in patients with femoroacetabular impingement. The study was single-centre and single-surgeon, and had the characteristics of a prospective study.
All the patients studied underwent a surgical hip dislocation for femoroacetabular impingement. Eight patients underwent reconstruction of the acetabular labrum with the ligamentum teres, 24 underwent repair of the labrum and 24 partial excision. Failure was defined as conversion of the procedure to total hip arthroplasty. The mean follow-up of the patients was 9.8 years ± 2.6.
Significant postoperative improvement was seen in the hip rating scales WOMAC total, WOMAC function, HOOS-QoL, HOOS-ADL and HOOS-SRA. There was no statistically significant difference between the three groups. In all, ten patients underwent total hip arthroplasty, at a mean interval of 7.9 ± 3.5 years.
The authors concluded that comparing repair and partial excision with reconstruction of the acetabular labrum using the ligamentum teres gives similar results for hip survivorship, taking total arthroplasty as the final outcome, and similar improvements in the hip rating scales. The technique used to treat the acetabular labrum can therefore be adapted to the nature of the damage to that structure in each patient, with an “a la carte” approach.
Source: “Journal of Hip Preservation Surgery”, July 2022