Arthroscopic Primary Labral Reconstruction in the Hip: Minimum 10-Year Outcomes With a Nested Propensity-Matched Control

Background: Labral reconstruction demonstrates promising short- and midterm benefits for irreparable labral tears, but long-term outcomes remain understudied. Purpose: To evaluate minimum 10-year patient-reported outcomes (PROs) of primary arthroscopic labral reconstruction compared with a propensity-matched control group. Study Design: Cohort study; Level of evidence, 2. Methods: Data were prospectively collected for all patients who underwent primary arthroscopic labral reconstruction with allograft as treatment for femoroacetabular impingement and labral tears. Patients included had preoperative and 10-year minimum postoperative data for PROs. Patients were propensity-matched to a control group that had undergone primary labral repair in a 1:3 ratio based on age, sex, body mass index, and acetabular Outerbridge grade. Patient characteristics and PROs were reported and compared between the groups. Rates of meeting clinically relevant thresholds, secondary arthroscopy, and survivorship were also compared. Results: A total of 22 hips (22 patients) of 27 eligible hips (81%) that underwent primary labral reconstruction (RECON) were matched to 66 hips (63 patients) that underwent primary repair (REPAIR). Both groups had similar preoperative and postoperative scores for all PROs ( P > .05). The RECON group met the substantial clinical benefit for the Non-Arthritic Hip Score at a lower rate than the REPAIR group ( P < .05). The RECON group underwent secondary arthroscopy at similar rates to the REPAIR group (13.6% vs 10.6%; P > .05) and had similar rates of survivorship (90.9% vs 81.8%; P > .05). Conclusion: Primary labral reconstruction demonstrated favorable outcomes at a minimum 10-year follow-up. When compared with a propensity-matched control group that underwent primary labral repair, both groups achieved similar postoperative PRO scores. Additionally, they met clinically meaningful thresholds and underwent secondary procedures at comparable rates.