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Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There a Difference Between an Autograft and Allograft?
BACKGROUND: Labral reconstruction has been described as a solution for the irreparable labrum. Initial techniques employed autografts, while more recent procedures have utilized allografts. No study, to our knowledge, has compared graft types. PURPOSE: To compare outcomes between patients who underw...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434443/ https://www.ncbi.nlm.nih.gov/pubmed/30937319 http://dx.doi.org/10.1177/2325967119833715 |
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author | Maldonado, David R. Lall, Ajay C. Laseter, Joseph R. Kyin, Cynthia Chen, Jeffrey W. Go, Cammille C. Domb, Benjamin G. |
author_facet | Maldonado, David R. Lall, Ajay C. Laseter, Joseph R. Kyin, Cynthia Chen, Jeffrey W. Go, Cammille C. Domb, Benjamin G. |
author_sort | Maldonado, David R. |
collection | PubMed |
description | BACKGROUND: Labral reconstruction has been described as a solution for the irreparable labrum. Initial techniques employed autografts, while more recent procedures have utilized allografts. No study, to our knowledge, has compared graft types. PURPOSE: To compare outcomes between patients who underwent primary labral reconstruction with a hamstring allograft versus hamstring autograft. HYPOTHESIS: No significant differences in outcomes will be found between patients who underwent primary labral reconstruction with an allograft versus autograft. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data from September 2010 to March 2015 were reviewed. Inclusion criteria were primary hip arthroscopic surgery with labral reconstruction using either a hamstring allograft (ALLO group) or autograft (AUTO group), with minimum 2-year follow-up scores for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Exclusion criteria were previous ipsilateral hip surgery, previous hip conditions, preoperative Tönnis osteoarthritis grade >1, and workers’ compensation claims. Significance was set at P = .05. RESULTS: Twenty-nine patients (29 hips) were included (85.3% follow-up). There were 17 patients (17 hips) in the ALLO group and 12 patients (12 hips) in the AUTO group. All patient-reported outcome scores demonstrated significant improvements at latest follow-up except for the mHHS for the AUTO group (P = .064). Comparisons between the ALLO and AUTO groups at the preoperative and latest follow-up time points showed no significant differences (preoperative mean [range]: mHHS, 67.5 [33.0-100.0] and 65.8 [29.0-96.0], respectively [P = .826]; NAHS, 65.6 [26.3-92.5] and 58.5 [35.0-79.0], respectively [P = .322]; HOS-SSS, 43.7 [12.5-100.0] and 40.1 [19.0-78.0], respectively [P = .707]) (latest follow-up mean [range]: mHHS, 86.4 [56.0-100.0] and 81.4 [57.0-100.0], respectively [P = .46]; NAHS, 87.7 [60.0-100.0] and 82.4 [56.3-100.0], respectively [P = .396]; HOS-SSS, 81.7 [0.0-100.0] and 70.9 [27.8-100.0], respectively [P = .423]). CONCLUSION: Primary arthroscopic hip labral reconstruction yielded improvements in patient-reported outcome scores and high patient satisfaction. In this small series, no differences were found in clinical outcomes between hamstring allografts and autografts. Based on these results, hamstring allografts and autografts may be considered comparable graft choices for primary reconstruction. Because of the avoidance of donor site morbidity and the possible increase in patient satisfaction, allografts may be the preferred choice in a surgical setting when they are accessible. |
format | Online Article Text |
id | pubmed-6434443 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-64344432019-04-01 Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There a Difference Between an Autograft and Allograft? Maldonado, David R. Lall, Ajay C. Laseter, Joseph R. Kyin, Cynthia Chen, Jeffrey W. Go, Cammille C. Domb, Benjamin G. Orthop J Sports Med Article BACKGROUND: Labral reconstruction has been described as a solution for the irreparable labrum. Initial techniques employed autografts, while more recent procedures have utilized allografts. No study, to our knowledge, has compared graft types. PURPOSE: To compare outcomes between patients who underwent primary labral reconstruction with a hamstring allograft versus hamstring autograft. HYPOTHESIS: No significant differences in outcomes will be found between patients who underwent primary labral reconstruction with an allograft versus autograft. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data from September 2010 to March 2015 were reviewed. Inclusion criteria were primary hip arthroscopic surgery with labral reconstruction using either a hamstring allograft (ALLO group) or autograft (AUTO group), with minimum 2-year follow-up scores for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Exclusion criteria were previous ipsilateral hip surgery, previous hip conditions, preoperative Tönnis osteoarthritis grade >1, and workers’ compensation claims. Significance was set at P = .05. RESULTS: Twenty-nine patients (29 hips) were included (85.3% follow-up). There were 17 patients (17 hips) in the ALLO group and 12 patients (12 hips) in the AUTO group. All patient-reported outcome scores demonstrated significant improvements at latest follow-up except for the mHHS for the AUTO group (P = .064). Comparisons between the ALLO and AUTO groups at the preoperative and latest follow-up time points showed no significant differences (preoperative mean [range]: mHHS, 67.5 [33.0-100.0] and 65.8 [29.0-96.0], respectively [P = .826]; NAHS, 65.6 [26.3-92.5] and 58.5 [35.0-79.0], respectively [P = .322]; HOS-SSS, 43.7 [12.5-100.0] and 40.1 [19.0-78.0], respectively [P = .707]) (latest follow-up mean [range]: mHHS, 86.4 [56.0-100.0] and 81.4 [57.0-100.0], respectively [P = .46]; NAHS, 87.7 [60.0-100.0] and 82.4 [56.3-100.0], respectively [P = .396]; HOS-SSS, 81.7 [0.0-100.0] and 70.9 [27.8-100.0], respectively [P = .423]). CONCLUSION: Primary arthroscopic hip labral reconstruction yielded improvements in patient-reported outcome scores and high patient satisfaction. In this small series, no differences were found in clinical outcomes between hamstring allografts and autografts. Based on these results, hamstring allografts and autografts may be considered comparable graft choices for primary reconstruction. Because of the avoidance of donor site morbidity and the possible increase in patient satisfaction, allografts may be the preferred choice in a surgical setting when they are accessible. SAGE Publications 2019-03-25 /pmc/articles/PMC6434443/ /pubmed/30937319 http://dx.doi.org/10.1177/2325967119833715 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Maldonado, David R. Lall, Ajay C. Laseter, Joseph R. Kyin, Cynthia Chen, Jeffrey W. Go, Cammille C. Domb, Benjamin G. Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There a Difference Between an Autograft and Allograft? |
title | Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There
a Difference Between an Autograft and Allograft? |
title_full | Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There
a Difference Between an Autograft and Allograft? |
title_fullStr | Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There
a Difference Between an Autograft and Allograft? |
title_full_unstemmed | Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There
a Difference Between an Autograft and Allograft? |
title_short | Primary Hip Arthroscopic Surgery With Labral Reconstruction: Is There
a Difference Between an Autograft and Allograft? |
title_sort | primary hip arthroscopic surgery with labral reconstruction: is there
a difference between an autograft and allograft? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434443/ https://www.ncbi.nlm.nih.gov/pubmed/30937319 http://dx.doi.org/10.1177/2325967119833715 |
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