TP3.2 Arthroscopic Labral Repair and Reconstruction for Pincer Impingement: A Multicenter Study Group Experience

Abstract Biography I have been closely involved in founding and leading multicenter orthopedic research groups. I have founded and am president of Multicenter Arthroscopy Study of the Hip (over 10,000 patient data entries) (www.mashstudy.com), in addition to more recently, the Multicenter Arthroscopy Study of the Ankle and Foot (www.mastafstudy.com). The MASH study was started over 10 years ago and we currently have 9259 participants with 25 publications. In addition, I am a founding member and currently serve on HIPSTR (hipstr.org), the national registry for hip arthroscopy, which currently has over 5000 patients. With over 10 years of experience and multicenter research, I have learned many of the pitfalls and have intimate knowledge of the challenges including surgeon/institution enrollment, patient enrollment, IRB approvals, compliance, and data management. Purpose To compare 2-year outcomes for patients with pincer impingement who underwent labral repair compared to labral reconstruction. Introduction Pincer impingement has been treated with both labral repairs and labral reconstructions, but there is limited comparative outcome data available. Methods Four hundred seventy-three patients with pincer impingement who underwent arthroscopic labral surgery for femoroacetabular impingement syndrome (FAIS) were retrospectively identified from a multicenter database. Patients were categorized into the labral repair and the labral reconstruction cohorts. A minimum of two-year follow-up was required. Patients with femoral head chondrosis and avascular necrosis were excluded from the analysis. Patient-reported outcomes were measured via the International Hip Outcome Tool-12 (iHOT-12) assessment. Paired t-tests were utilized to examine within-group differences from baseline to follow-up. Unpaired t-tests were utilized to examine between-group differences between the repair and the reconstruction cohorts. The proportion of patients who met the Patient Acceptable Symptom State (PASS), Substantial Clinical Benefit (SCB), and Minimal Clinically Important Difference (MCID) was analyzed. Chi-square tests were used to compare these proportions across cohorts. Results The average age of the total cohort was 40 ± 12.82 years. 66.95% of the total cohort were female. Three hundred ninety-nine patients underwent labral repair and 74 patients underwent labral reconstruction. The average baseline and follow-up iHOT-12 scores for the repair cohort were 39.26 ± 19.41 and 74.74 ± 25.87, respectively. Furthermore, the average baseline and follow-up iHOT-12 scores for the reconstruction cohort were 39.85 ± 18.58 and 74.65 ± 26.95, respectively. The labral repair and reconstruction cohorts both demonstrated statistically significant improvements in iHOT-12 compared to baseline (both p < 0.001). There was no statistically significant difference in mean iHOT-12 improvement between the labral repair and reconstruction groups (p = 0.92). There was no significant difference between cohorts in the proportion of patients who met MCID, SCB, and PASS (χ2(1, N = 473) = 0.00, p = .99; χ2(1, N = 473) = 1.16, p = .28; and χ2(1, N = 473) = 0.18, p = .67), respectively. Conclusion Both labral repair and labral reconstruction are efficacious treatment options for patients with pincer impingement.