Acetabular Labral Reconstruction With an Iliotibial Band Autograft

Abstract

Background: Injury to the acetabular labrum results from multiple causes including femoroacetabular impingement, dysplasia, and acute trauma. The patient’s labrum can be reconstructed utilizing an iliotibial band autograft that is tubularized and fixed to the acetabular rim, substituting for the patient’s own labrum. Purpose/Hypothesis: The purpose of this study was to evaluate the midterm results of this technique with a follow-up from 3 to 6 years after reconstruction. The hypothesis was that midterm results would show excellent patient-reported outcomes and high patient satisfaction with outcome. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of a prospectively collected registry was undertaken that identified 75 patients (76 hips) who underwent arthroscopic labral reconstruction using an iliotibial band autograft by a single surgeon from February 2005 to August 2008. Modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), and patient satisfaction level (on a scale of 1-10) were recorded preoperatively and postoperatively annually. Survivorship analysis curves were created to evaluate the effectiveness of this technique. Results: Among 76 hips, 19 progressed to total hip arthroplasty at an average of 28 months from the procedure. Mean survivor time (no arthroplasty) was 59.1 months (95% CI, 53.9-64.4). Follow-up on the surviving hips was available for 49 patients (86%) with a mean follow-up time of 49 months (range, 36-70 months). The mHHS significantly increased from a preoperative mean of 58.9 to the most recent follow-up score averaging 83 ( P = .0001); HOS values in the sports and the activities of daily living subscales also increased significantly ( P = .0001 and P = .001, respectively). Median patient satisfaction with outcome was 8. A joint space of ≤2 mm was found to be a poor prognostic factor for survival of the hip. Conclusion: Arthroscopic labral reconstruction using an iliotibial band autograft resulted in a survivorship of 56 months. Of the 76% of patients who did not require total hip arthroplasty, improvement in function and high satisfaction with outcome were reported. Joint space of ≤2 mm is a contraindication for acetabular labral reconstruction.