Objectives: Preliminary findings in the literature suggest that treatment with bone marrow aspirate concentrate (BMAC) at the time of hip arthroscopy is a potentially viable solution to improve outcomes in patients with cartilage degradation concomitant to acetabular labral tearing; however, functional scores to date have not eclipsed 24 months. Therefore, the present study compares minimum five-year outcomes in patients treated with or without BMAC augmentation to address chondral damage during arthroscopic labral repair. Methods: This is a case-control study analyzing prospectively collected data in patients who underwent acetabular labral repair from a single surgeon between May 2014 and January 2019. Patients were stratified into either the 1) BMAC cohort or the 2) control cohort depending on whether or not BMAC was used to address chondrolabral junction breakdown secondary to femoroacetabular impingement (FAI) and labral tearing during surgery. Patients were only included for data analysis if they: 1) underwent primary acetabular labral repair on their affected hip and 2) completed PROMs preoperatively and at 60 months after surgery. Exclusion criteria consisted of: 1) previous ipsilateral hip arthroscopy; 2) labral debridement; 3) a lateral center edge angle (LCEa) of 0.05). At 24 months, patients treated with BMAC reported significantly higher mHHS (91.7 85.7, 97.7 versus 82.1 76.6, 87.6; p = 0.004), iHOT-33 (86.3 77.5, 95.1 versus 74.2 66.2, 82.2; p = 0.012), and HOS-ADL (93.9 87.9, 99.8 versus 85.0 79.6, 90.5; p = 0.008) scores. This trend continued at 60 months, as patients treated with BMAC showed significantly higher mHHS (95.5 89.6, 100.0 versus 83.9 78.4, 89.4; p < 0.001), iHOT-33 (91.5 82.7, 100.0 versus 78.3 70.2, 86.3; p = 0.006), and HOS-SS (87.7 75.7, 99.7 versus 71.4 60.4, 82.4; p = 0.012) scores. These results held in the unadjusted sensitivity analyses ( Figure 1 ). Conclusions: Patients who underwent BMAC augmentation during arthroscopic labral repair outperformed patients who underwent labral repair alone without BMAC. This difference started to manifest at 12 months postoperatively and steadily increased in contrast until 5 years after surgery. These findings remain consistent with short-term reports and add mid-term outcomes to the growing body of literature that describes the patient-reported effect of BMAC as an adjuvant therapy during hip arthroscopy.
Martin et al. (Mon,) studied this question.