Abstract
BACKGROUND: Labral eversion has recently been described as an anatomic variation in a nondysplastic patient with impingement-type hip pain and an otherwise intact labrum that is associated with microinstability. PURPOSE: To compare clinical outcomes after hip arthroscopy between patients with hip microinstability caused by everted labrums and those with femoroacetabular impingement (FAI). STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study included patients who underwent surgery at a tertiary hospital center between 2015 and 2022 after failure of nonoperative treatment for at least 6 months. Data-including demographic characteristics, body mass index, visual analog scale (VAS) scores, and preoperative and long-term follow-up Hip Outcome Score (HOS), lateral center-edge angle (LCEA), and upsloping lateral sourcil-were collected from the clinical records. The same surgical team treated all patients, followed the same rehabilitation protocol, and observed them for a minimum of 24 months. Clinical improvement was evaluated using HOS, VAS, and return to sports outcomes. Patients were organized into 2 groups. Group 1 included patients with an intraoperative diagnosis of everted labrum, whereas group 2 served as the control group, consisting of patients with classic FAI associated with labral tears. Statistical analysis was performed using the t test and 95% CI. RESULTS: A total of 76 patients (n = 88 hips) who underwent hip arthroscopy during the study period were divided into 2 groups. We found a greater presence of upsloping lateral acetabular rim in group 1 (65% vs 11%; P = 4.77 × 10(-7)). Group 1 demonstrated a significantly greater LCEA compared with group 2 (37.1° vs 34.6°, respectively; P = .010). The HOS scores were 91.6 and 92.2 (P = .226) and 97.8 and 98.1 (P = .575) in groups 1 and 2, respectively, at 6 and 12 months postoperatively. Furthermore, postoperative VAS scores were not significantly different between the 2 groups (P = .574). CONCLUSION: Our study demonstrated that clinical and functional outcomes are not significantly different between patients operated on for an everted labrum with intra-articular anchor placement technique and those operated on for normal labral tears in FAI.These findings suggest that, when appropriately identified and treated with a technique focused on restoring the labral seal, the everted labrum does not negatively affect long-term postoperative results. Recognition and proper management of this anatomic variant are therefore essential in achieving successful surgical outcomes.