FP3.1 Minimum 5-Year Outcomes Following Arthroscopic Management of Femoro-Acetabular Impingement (FAI. A Matched Study of Labral Excision Vs Labral Repair

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ID: 330964
2026
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Abstract
Abstract ICLB03 - The Labral Reconstruction Masterclass: Autografts, Allografts, and Technical Frontiers, Session Room 12 (BMCC Level 3), October 8, 2026, 10:30 - 12:30 Background An irreparable labrum, damaged as a result of chronic FAI, is commonly managed with resection of the irreparable segment or more recently reconstruction using autograft. Optimising joint anatomy and restoring function by removing bony deformity, preserving where possible the chondrolabral junction and articular cartilage surface, and protecting and repairing the capsule, following labral segmental excision, could potentially result in a successful outcome and avoid a reconstruction procedure. Methods A review of a single-surgeon, institutional hip preservation registry for cases undergoing primary hip arthroscopy of FAI between 2009-March 2021 was performed. Exclusion: Tonnis>1, concomitant pathologies, dysplasia(LCEA <25°). Patients were assigned to one of two groups: Segmental labral excision or labral repair (controls). 1:3 case-control matching was based on sex, age(±2 years), capsular repair, Tonnis grade, year of surgery. Survivorship (endpoints THR conversion and repeat arthroscopy), and PROMs(mHHS, UCLA, SF36 and WOMAC) at 5-years post-op were compared between groups. Results 57 Excisions and 1776 Repairs met the inclusion criteria. 41 Excisions were matched with 123 Repairs, mean age 29.8 years(p=0.954), 100% male, 59% Tonnis 0. LCEA(p=0.009, d=0.485) and AA(p=0.026, d=0.421) were significantly larger in Excisions compared to Repairs. 2 THR conversions in Repair vs 0 in Excision: THR Survivorship 98.2% vs 100%, p=0.430. 9 repeat arthroscopies in Repair vs 0 in Excision: Repeat arthroscopy Survivorship 92.1% vs 100%, p=0.093. Post-operatively, the mHHS was higher in Repairs compared to the Excisions (97.9 vs 90.3, p=0.020). No significant difference between groups for any other PROMs post-operatively: UCLA (p=0.288), SF36 (p=0.269), WOMAC (p=0.147) Magnitude of change in scores from pre- to post-op was greater in the Repairs compared to the Excisions for mHHS (13.2 (IQR 23.1) vs 4.4 (19.8), p=0.012) and UCLA (0 (4) vs 0 (2), p=0.036). No difference between groups for SF36 (p=0.997) or WOMAC (p=0.147). Conclusion In this all-male cohort improvements in mHHS, SF36 and WOMAC were observed in both groups, with magnitude of observed change greater for Repairs compared to Excisions. Similar high rate of survivorship was observed in patients undergoing arthroscopic correction of FAI where excision of an irreparable segment of labrum had been undertaken compared with those having a labral repair. Labral reconstruction may not be necessary to have a successful mid-term outcome.
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Authors David Filan, Patrick Carton, Karen Mullins
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.017
URL
https://doi.org/10.1093/jhps/hnag043.017
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