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SEX-SPECIFIC OUTCOMES AFTER ARTHROSCOPIC HIP LABRAL REPAIR AND RECONSTRUCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

PURPOSE: The purpose of this study is to conduct a systematic review to evaluate and compare sex-specific outcomes after arthroscopic hip labral repair or reconstruction. METHODS: A systematic review of the literature was conducted using PubMed, Cochrane, Embase, and Web of Science databases according to PRISMA guidelines. ROBINS-I Tool was utilized for the risk of bias assessment. Eligible studies included patients who underwent arthroscopic hip labral repair or reconstruction, reported sex-based outcomes, and were published between 2005 and 2024. Main exclusion criteria included studies not written in English, cadaveric studies, animal studies, and studies who failed to stratify outcomes based on sex. The main outcomes of interest were mHHS (modified Harris Hip Score), Hip Outcome Score-Sport Scale (HOS-SS) score, Visual Analogue Scale for Pain (VAS Pain) score, revision rates, and return to sport (RTS) rates. RESULTS: Of the 3 studies that reported RTS attempts, there was a trend toward males achieving a greater success rate than females, 85.1% compared with 81.6%, (odds ratio, 1.27 [95% CI, 0.65; 2.48], p=0.45, I2=0%). Across 5 studies, males had a lower revision rate of 7% compared with a 12.2% revision rate in females (odds ratio, 0.44 [95% CI, 0.23; 0.83], p=0.19, I2=38%). There was a statistically significant difference in VAS Pain scores between males and females of 3 studies, with slightly higher scores in females, however the standardized mean difference was small (mean difference, 0.08 [95% CI, -0.24; 0.41], p=0.05, I2=67%). Males and females recorded similar scores for mHHS and HOS-SS and there was no significant difference or trend appreciated. CONCLUSION: The meta-analyses demonstrated a trend toward more females requiring revisions and having less successful RTS attempts. The practical relevance of the difference in VAS Pain scores is negligible, as evidenced by the small mean difference. Overall, the relatively equal functionality scores (mHHS and HOS-SS), low pain levels, low rates of revision, and high rates of RTS suggest that hip labral repairs and reconstructions are beneficial to both males and females.

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