Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement: a prospective randomized study.

Abstract

PURPOSE:

The purpose of this prospective randomized study was to compare the outcomes of arthroscopic labral repair and selective labral debridement in female patients undergoing arthroscopy for the treatment of pincer-type or combined pincer- and cam-type femoroacetabular impingement.

METHODS:

Between June 2007 and June 2009, 36 female patients undergoing arthroscopic hip treatment for pincer- or combined-type femoroacetabular impingement were randomized to 2 treatment groups at the time of surgery: labral repair or labral debridement. The repair group comprised 18 patients with a mean age of 38; the debridement group comprised 18 patients with a mean age of 39. All patients underwent the same rehabilitation protocol postoperatively. At a minimum of 1 year, all patients were assessed using a validated Hip Outcome Score (HOS) to determine hip function, and also completed a simple subjective outcome measure.

RESULTS:

All 36 patients were available for follow-up at an average time of 32 months (range, 12 to 48). In both groups, HOSs for activities of daily living (ADL) and sports improved significantly from before surgery to the final follow-up (P < .05). The postoperative ADL HOS was significantly better in the repair group (91.2; range, 73 to 100) compared with the debridement group (80.9; range, 42.6 to 100; P < .05). Similarly, the postoperative sports HOS was significantly greater in the repair group (88.7; range, 28.6 to 100) than in the debridement group (76.3; range, 28.6 to 100; P < .05). Additionally, patient subjective outcome was significantly better in the labral repair group (P = .046).

CONCLUSIONS:

Arthroscopic treatment of femoroacetabular impingement with labral repair in female patients resulted in superior improvement in hip functional outcomes compared with labral debridement. In addition, a greater number of patients in the repair group subjectively rated their hip function as normal or nearly normal after surgery compared with the labral debridement group.

LEVEL OF EVIDENCE:

Level I, prospective randomized study.

• Authors: Aaron J Krych, Matthew Thompson, Zak Knutson, Joanna Scoon, Struan H Coleman
• Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) Vol. 29 Issue 1 Pg. 46-53 (Jan 2013) ISSN: 1526-3231 [Electronic] United States
• PMID: 23276413 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Topics

• Activities of Daily Living
• Adult
• Arthroscopy (methods)
• Athletic Performance
• Debridement (methods)
• Female
• Femoracetabular Impingement (diagnostic imaging, rehabilitation, surgery)
• Fibrocartilage (surgery)
• Follow-Up Studies
• Hip Joint (physiopathology)
• Humans
• Middle Aged
• Patient Satisfaction
• Prospective Studies
• Radiography
• Recovery of Function
• Severity of Illness Index
• Surveys and Questionnaires
• Treatment Outcome
• Young Adult