Clinical Outcomes After Arthroscopic Hip Labral Repair Using Looped Versus Pierced Suture Techniques
Bibliographic record
Abstract
BACKGROUND: With an improved understanding of the importance of the labrum, labral repair is replacing labral debridement as a component of hip arthroscopy for femoroacetabular impingement. Labral repair can be performed by passing suture limbs either around (looped) or through (pierced) the labral tissue. PURPOSE: To determine whether there is any clinical difference between these different labral repair techniques. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A prospective data registry was queried for patients who underwent primary hip arthroscopy with labral repair from 2009 to 2011. Patients older than 18 years who had undergone labral repair were included in the study. Exclusion criteria included previous hip surgery, avascular necrosis, joint space less than 2 mm, and labral reconstruction or augmentation. Patients were grouped based upon the 3 labral repair techniques: looped, pierced, or combined. Statistical equivalence testing was performed to evaluate the primary outcome measure, the Hip Outcome Score-activities of daily living subscale (HOS-ADL). Other measures included the HOS-sport subscale (HOS-Sport), modified Harris hip score (mHHS), Short Form-12 (SF-12), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and patient satisfaction with outcome (1-10 scale; 10 = very satisfied). RESULTS: Preoperative scores improved in the looped group (HOS-ADL, from 68 to 91; mHHS, from 64 to 83; HOS-Sport, from 51 to 81; and WOMAC, from 23 to 9), the pierced group (HOS-ADL, from 64 to 89; mHHS, from 62 to 83; HOS-Sport, from 46 to 77; and WOMAC, from 34 to 12), and the combined group (HOS-ADL, from 64 to 89; mHHS, from 63 to 83; HOS-Sport, from 52 to 79; and WOMAC, from 26 to 12). Median patient satisfaction in all groups was 9.0. The 3 labral repair groups were shown to be statistically and clinically equivalent (P < .05) with respect to the validated HOS-ADL to within a clinically irrelevant threshold at mean 36-month follow-up. In addition, there were no differences in secondary outcome measures or in the revision rate (looped, 7% [14/209], pierced, 8% [5/65], and combined, 6% [5/83]). CONCLUSION: This study showed equivalent HOS-ADL outcomes between looped, pierced, and combined labral repairs. Secondary outcome measures, including failure and revision rates, were not significantly different among the groups. Thus, suture type did not influence outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".