FP4.6 Biological augmentation of acetabular repair superior to mechanical labral repair only: 5-year results in prospective controlled study

Abstract ICLA04 - The Labral Repair Blueprint: Mastering Anchorage, Suture Loops, and Everyday Success, Auditorium B (BMCC Level 1), October 8, 2026, 10:30 - 12:30 Introduction Acetabular labrum is known to enhance hip stability. Previous studies have shown improved function with repair versus debridement. Biological augmentation of labrum repair with mesenchymal stromal cells (MSCs) have been postulated to improve success rates. Aims To establish long term results of labral repair augmented with MSCs (biologically augmented group) compared to mechanical repair of acetabular labrum (control group) controlling for confounders, at 5 years. Methods Study design was that of prospective case-control study. A total of 140 patients undergoing hip arthroscopy for femoroacetabular impingement with an aacetabular labrum tear and minimum 5-year follow-up were included. In biologically augmented group the traditional anchor repair of the labrum was augmented with bone marrow harvested MSCs. In the control group the labrum was stabilized with anchors only. Both groups had 70 hips each. Patients with ossified labrum, irreparable labrum or undergoing labral reconstruction were excluded. Data were collected pre/per/post-operatively at 6, 26 weeks and annually. Demographics, site of labral tear, state of chondral surfaces, radiographic parameters, modified Harris Hip Score(mHHS), VAS for satisfaction(0-10), Non-Arthritic Hip Score(NAHS) and adverse events were recoreded. Minimum follow-up was 60-months. Descriptive statistics, t-test for parametric and chi-squared test for non-parametric variables were employed with alpha at 5% and beta at 80%. Results Mean age in biologically augmented and control-group was 42.6 (19 ,61) and 44.2 (19, 54) respectively. Majority of labral tears were anterosperior. Pre-operative mean scores improved in the biologically augmented group (mHHS from 66.2 to 91.2 (p<0.001), VAS from median 5 to 9 (0-10), mean NAHS from 64 to 88 (p<0.01) and in control-group (mHHS from 65.5 to 88, VAS from median 6 to median 9, mean NAHS from 64 to 87(p<0.01). The improvement remained sustained in majority of patients in both groups at 5 years. In biologically augmented and control groups the revision hip arthroscopy rate was 1.4% and 2.8%, and conversion to hip replacement rate 0%and 1.4% respectively. Conclusion The MSC augmentation group appears to offer safe and effective treatment and results are better sustained than the repair only control-group at 5 years. However, MCID was achieved in both groups.