Clinical and functional outcome after acetabular labral repair in patients aged older than 50 years

Tomer Ben Tov, Eyal Amar, Amir Shapira, Ely Steinberg, Ehud Atoun, Ehud Rath
Arthroscopy: the Journal of Arthroscopic & related Surgery 2014, 30 (3): 305-10

PURPOSE: To assess the clinical and functional outcome of labral repair in patients aged older than 50 years.

METHODS: We performed a prospective analysis of 20 patients aged older than 50 years who had undergone arthroscopic repair of a torn acetabular labrum (6 men and 14 women; mean age, 58 years). The indication for surgery was groin pain due to various causes with or without associated mechanical symptoms that did not respond to nonoperative treatment for more than 6 months. Intraoperatively, all patients were diagnosed with labral pathology. The mean duration of symptoms was 3.1 years (range, 0.5 to 15 years). The mean follow-up period was 22 months (range, 12 to 35 months). The outcome was prospectively measured with the modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS).

RESULTS: The indication for surgery was femoroacetabular impingement (FAI) with cam deformity and a labral tear in 4 patients, FAI with pincer deformity and a labral tear in 1 patient, FAI with both deformities in 1 patient, a gluteus medius tear in 2 patients, and an isolated labral tear in 12 patients. Acetabular chondral lesions were present in 11 patients (55%). The mean preoperative and postoperative MHHS was 62.5 and 87.2, respectively (P < .001); the mean preoperative and postoperative HOS was 42.7 and 86.3, respectively (P < .001); and the mean preoperative and postoperative level of function during usual activities of daily living according to the HOS was 46.0% and 73.7%, respectively (P < .001). No significant difference was identified in MHHS and HOS between gender groups.

CONCLUSIONS: Arthroscopic management of FAI and labral repair in patients aged older than 50 years without significant arthritis (Tönnis grade 1 or better) are associated with significant improvement in outcome. Because of the potential importance of the labrum for long-term hip joint integrity, we advocate repair of the labrum in patients aged older than 50 years when possible.

LEVEL OF EVIDENCE: Level IV, therapeutic case series.

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