B. Domb (Des Plaines, US)

American Hip Institute

Presenter Of 1 Presentation

Podium Presentation Clinical Outcome

12.1.4 - Radiologic and Demographics Risk Factors for Labral Reconstruction versus Repair in Primary Hip Arthroscopy. A Predictive Model

Presentation Number
12.1.4
Presentation Topic
Clinical Outcome
Lecture Time
17:27 - 17:36
Session Type
Free Paper Session
Corresponding Author
Disclosure
B.Domb: Research Support: Arthrex, Medacta, Stryker; Shareholder: American Hip Institute, Hinsdale Orthopedic Associates, Munster Specialty Surgery Center, North Shore Surgical Suites, SCD#3; Paid Instructor: Arthrex, Pacira Pharmaceuticals; Employee: AAN

Abstract

Purpose

To determine if there any radiologic or demographic risk factors for labral reconstruction versus repair in primary hip arthroscopy.

Methods and Materials

This retrospective study draws from a prospectively and longitudinally maintained institutional database. Inclusion criteria were patients who underwent primary hip arthroscopy and received either labral reconstruction or simple labral repair by the senior author between October 2010 to November 2018. Exclusion criteria were patients with previous hip conditions. 14 radiographic measurements were reported.

Results

251 hips (237 patients) with primary labral reconstruction and 1147 hips with (1063 patients) primary labral repairs were identified from the institution’s database as having complete sets of radiographic measurements. Radiographically there was a greater prevalence of Tönnis 1 grade in the reconstruction group(0.37 vs 0.15). Patients who underwent reconstruction also had greater degree of acetabular coverage as measured by LCEA(33.25±7.31° vs 30.41±6.22°) and AI(3.45±5.26° vs 4.77±4.79°). Alpha angle(AA) was also higher(65.11±13.21° vs 59.45±12.21°). The average age of patients who underwent reconstruction was 40.99±11.74 years, while that of those who underwent repair was 34.98±13.57 years. The former cohort of patients had BMI of 27.4±5.42 kg/m2, while that of the later was 25.69±5.04 kg/m2. There was a greater proportion of males in the reconstructed group(0.36 vs 0.45). A final logistic regression selected age, BMI and three of the 14 predictive radiographical findings(Tönnis Grade, LCEA, AA). The odds of reconstruction were 2.52 times higher in those with Tönnis Grade 1 vs 0. Every additional degree in LCEA was associated with a 6% increase in the odds of reconstruction and 4% for each additional degree increase in alpha angle. The model accuracy is 70.5% with a ROC area = 0.74.

Conclusion

There is a direct proportional relation between the odds of primary labral reconstruction and age at surgery, BMI, gender, Tönnis grade, LCEA, and AA.

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