Caution Urged for Arthroscopic Debridement of Labral Tears

Researchers have linked arthroscopic acetabular labral debridement in patients 45 and older with a 17 percent reoperation rate at a mean of 21.3 months and minimal overall improvement in joint-specific outcome measures.

Geoffrey Wilkin, M.D., and colleagues from The Ottawa Hospital in Ottawa, Canada,studied the WOMAC (Western Ontario and McMaster osteoarthritis index), SF-12 and modified Harris Hip Scores (mHHS) of 41 patients who were at least 45 years old at the time of arthroscopic acetabular labral debridement.

There were seven reoperations, of which six involved conversion to hip arthroplasty or resurfacing. Study results showed the hip arthroscopy group improved from 15.4 points to 6.1 points in their mean WOMAC pain and function scores, SF-12 physical component summary score and mHHS. However, changes in the WOMAC stiffness and SF-12 mental component summary scores were not significant. Postoperative mHHS showed good or excellent outcomes in 13 patients, the data indicated.

“The results in the present series of patients suggest that arthroscopic labral debridement has a much lower overall clinical benefit in patients who are 45 years of age or older than in younger patients,” the researchers wrote in their study. “Since it remains difficult to predict which patients are likely to derive clinical benefit and since the overall benefit was small, arthroscopic debridement of acetabular labral tears in older patients should be approached with caution.”