Authors: J W Thomas Byrd
Publish Date: 2016/11/10
Volume: 475, Issue: 4, Pages: 1189-1191
Abstract
This CORR Insights® is a commentary on the article “Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10year Survivorship Compared With Resection” by Anwander and colleagues available at DOI 101007/s1199901651147The author certifies that he or a member of his immediate family has no funding or commercial associations eg consultancies stock ownership equity interest patent/licensing arrangements etc that might pose a conflict of interest in connection with the submitted articleLabral tear management has progressed considerably during the last quarter century The change began when we recognized the existence of these disorders as a cause of pain and dysfunction 2 Débridement alone often resulted in measurable improvement providing some hope for these patients who in the past simply were resigned to living within the constraints of their symptoms 3 Subsequently understanding of the etiology has strengthened the ability to address the causation with an opportunity for more durable results 5 Crediting the intuition experience and observations of accomplished clinicians there is a growing body of evidence to support the role of restoration over simple débridement of the acetabular labrumIn a landmark article on the topic Espinosa and colleagues 4 reported superior Merle d’Aubigné scores and less radiographic progression of arthritis when the labrum was restored after taking it down for performing an acetabular rim trimming compared to prior experiences when it was simply excised In the arthroscopic setting labral repair was found to be a predictor of better outcomes over debridement in the presence of FAI based on the modified Harris Hip Score 9 Another study 7 similarly noted better modified Harris Hip Scores in the correction of FAI when the labrum was repaired compared to débridement In a randomized controlled study of débridement versus repair among women 6 the study authors again observed superior results using the Hip Outcomes Score when the labrum was restored In the current study Anwander and colleagues present a 10year followup on the original series by Espinosa and colleagues 4 demonstrating increased mean survivorship among the labral reattachment group 78 compared to labral resection 46
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