Circumferential Repair Versus Labral Base Refixation for the Treatment of Symptomatic Femoroacetabular Impingement Syndrome: A Systematic Review and Narrative Synthesis
Bibliographic record
Abstract
Background: Hip arthroscopy is a common surgical treatment method for femoroacetabular impingement syndrome (FAIS) and typically involves labral repair. Suture limbs can either be placed around (circumferential repair technique) or through (labral base refixation [LBR] technique) the labrum; however, there remains a lack of consensus regarding the superiority of either technique. Purpose: To evaluate and narratively synthesize the available evidence on patient-reported outcome measure (PROM) scores of LBR and circumferential repair in patients undergoing hip arthroscopy and labral repair for FAIS. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic electronic search of MEDLINE, Embase, and the Cochrane Library was carried out on July 21, 2024. All English-language randomized controlled trials, comparative studies, and case series on adults with symptomatic FAIS were eligible for inclusion. Results: A total of 12 studies with 1488 patients were included in the analysis. Overall, 9 cohorts with 1035 patients and a mean age of 33.1 years were included in the circumferential repair group, and 6 cohorts with 453 patients and a mean age of 32.3 years were included in the LBR group.Both the circumferential repair and LBR techniques were associated with significant improvements on PROMs, including the mHHS (modified Harris Hip Score), HOS-ADL (Hip Outcome Score-Activities of Daily Living), HOS-SSS (Hip Outcome Score-Sports-Specific Subscale), NAHS (Non-Arthritic Hip Score), WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and VAS (visual analog scale). Postoperative scores were commonly >80 points across measures, with mean improvements of 20 to 30 points in function and 2 to 4 points in pain. Reported rates of revision surgery and conversion to total hip arthroplasty were low across both techniques, generally <10%, although some variability existed between studies. Conclusion: Both techniques led to improved PROM scores after hip arthroscopy for the management of FAIS. Given the heterogeneity and predominance of lower level evidence, future high-quality comparative studies are warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.028 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.008 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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 source (direct Gemma or distilled Codex), 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".