Background:An everted acetabular labrum (EL) is a pathologic variant in which the labrum is flipped to the capsular side of the acetabular rim. An iatrogenic EL is a known complication of a poorly executed labral repair, and a recent study described the native acetabular EL.Purpose:To analyze surgical outcomes after advancement or reconstruction of an EL in a native hip.Study Design:Cohort study; Level of evidence, 3.Methods:This was a multicenter retrospective review of prospectively collected data on primary hip arthroscopic surgeries performed between 2013 and 2023. An EL was identified arthroscopically as a labrum–femoral head gap while off traction in the native hip. All patients with EL who were analyzed in this study underwent arthroscopic labral repair and advancement or labral augmentation or reconstruction. Patients with hip dysplasia also underwent periacetabular osteotomy with or without a derotational femoral osteotomy. Patient-reported outcomes (PROs) were assessed using the 12-item International Hip Outcome Tool (iHOT-12) and the Nonarthritic Hip Score. PROs were obtained preoperatively and up to 24 months after surgery. PROs were compared with those of a case-matched control cohort in a 1:2 ratio. Only patients with PROs available at ≥1 year postoperatively were included in the outcome analysis.Results:A total of 111 patients (129 hips) with EL during the study period were identified, with PROs available in 96 hips. The mean age of patients with EL was 30.5 years, and women made up 87% of the cohort. Of the 129 hips with an EL, an isolated diagnosis of an EL was present in 11.6% of hips. Deficient acetabular coverage (lateral center-edge angle <25°) was seen in 40.6% of EL hips. No difference was seen in iHOT-12 scores between EL and control groups at 12- or 24-month follow-up ( P = .18 and .94, respectively). Patients with EL reported a significant improvement of PROs at latest follow-up ( P < .001 for iHOT-12 and Nonarthritic Hip Score).Conclusion:Surgical management of a native EL with restoration of the labral seal on the femoral head and correction of concomitant pathologies resulted in significant clinical improvement, with postoperative outcome scores comparable to those of patients without an EL. These findings provide evidence supporting surgical intervention for a native EL.

中文翻译：

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髋臼盂唇外翻：手术治疗的结果

背景：外翻髋臼唇（EL）是一种病理变异，其中盂唇翻转至髋臼边缘的囊侧。医源性 EL 是盂唇修复不良的一种已知并发症，最近的一项研究描述了天然髋臼 EL。目的：分析在天然髋关节中推进或重建 EL 后的手术结果。研究设计：队列研究；证据级别，3。方法：这是对 2013 年至 2023 年期间进行的初次髋关节镜手术前瞻性收集的数据进行的多中心回顾性审查。在原生髋部脱离牵引时，通过关节镜将 EL 识别为盂唇-股骨头间隙。本研究中分析的所有 EL 患者均接受了关节镜下盂唇修复和推进或盂唇增大或重建。髋关节发育不良患者还接受了髋臼周围截骨术，伴或不伴股骨去旋转截骨术。使用 12 项国际髋关节结果工具 (iHOT-12) 和非关节炎髋关节评分来评估患者报告的结果 (PRO)。 PRO 在术前和术后 24 个月内获得。 PRO 与病例匹配的对照组以 1:2 的比例进行比较。仅术后 1 年以上出现 PRO 的患者才纳入结果分析。 结果：研究期间共识别出 111 名 EL 患者（129 髋），其中 96 髋出现 PRO。 EL 患者的平均年龄为 30.5 岁，其中女性占 87%。在 129 个患有 EL 的髋关节中，11.6% 的髋关节被孤立诊断为 EL。 40.6% 的 EL 髋关节存在髋臼覆盖不足（横向中心边缘角 <25°）。在 12 或 24 个月的随访中，EL 组和对照组之间的 iHOT-12 评分没有差异（P 分别为 0.18 和 0.94）。 EL 患者报告在最近一次随访中 PRO 显着改善（iHOT-12 和非关节炎髋关节评分 P < 0.001）。结论：对天然 EL 进行手术治疗，恢复股骨头盂唇密封并矫正伴随的病理导致显着的临床改善，术后结果评分与没有 EL 的患者相当。这些发现提供了支持对原生 EL 进行手术干预的证据。