FP4.2 Arthroscopic Segmental Acetabular Labral Reconstruction Using a Modified Two-Portal KITE Technique: Minimum 2-Year Outcomes of a Consecutive Case Series

Abstract

Abstract ICLA04 - The Labral Repair Blueprint: Mastering Anchorage, Suture Loops, and Everyday Success, Auditorium B (BMCC Level 1), October 8, 2026, 10:30 - 12:30 Introduction The acetabular labrum plays a key role in hip stability, load distribution, and maintenance of the intra-articular fluid seal. In cases of irreparable labral tears, arthroscopic labral reconstruction has become an increasingly accepted treatment option. The aim of this study was to evaluate the clinical and functional outcomes of arthroscopic segmental acetabular labral reconstruction using tendon allograft at a minimum follow-up of 24 months. Secondary aims were to assess graft incorporation on magnetic resonance imaging (MRI) at 6 months postoperatively and to describe a modified two-portal KITE technique. Materials and Method A retrospective review was performed on consecutive patients who underwent arthroscopic segmental acetabular labral reconstruction between January 2021 and November 2023, including both primary and revision hip arthroscopies, all performed by a single surgeon. Inclusion criteria were age <45 years, irreparable labral tear, Tönnis grade 1–2, and failure of conservative treatment. Clinical outcomes were assessed using the Hip Disability and Osteoarthritis Outcome Score (HOOS), WOMAC, and Visual Analog Scale (VAS) for pain, collected preoperatively and at 12 and 24 months. In a subset of patients, postoperative MRI at 6 months was used to evaluate graft position, continuity, and integration. Results Twenty patients were included; 17 (85%) underwent primary hip arthroscopy and 3 (15%) revision arthroscopy. Nineteen patients completed clinical follow-up at 12 and 24 months. Median age at surgery was 30 years. All procedures were performed using the modified two-portal KITE technique; in 3 cases (15%), a third distal anterolateral accessory portal was required. HOOS scores improved from preoperative assessment to 12 months and were maintained at 24 months. WOMAC and VAS scores progressively decreased during follow-up. No intraoperative or postoperative complications were observed, and no patient required revision arthroscopy or conversion to total hip arthroplasty within 24 months. Postoperative MRI showed satisfactory graft position and continuity. Discussion These findings suggest that segmental acetabular labral reconstruction can provide clinically meaningful improvement in function and pain in appropriately selected patients. MRI findings also support the possibility of early graft integration at the acetabular rim. Conclusions Arthroscopic segmental acetabular labral reconstruction using a modified two-portal KITE technique is a reliable treatment option for irreparable labral tears, with favorable clinical outcomes at 2-year follow-up.