Restoration of Labral Function in Primary Hip Arthroscopy: From Labral Repair to Labral Reconstruction
Authors: Maldonado DR, Monahan PF, Domb BG
DOI: 10.1016/j.arthro.2021.08.003
Background
The acetabular labrum contributes significantly to joint stability, suction seal, and load distribution. This article reviews surgical approaches to restoring labral function, focusing on labral repair versus reconstruction.
Methods
This narrative review compares the clinical indications, techniques, and outcomes of labral repair (the standard treatment) versus labral reconstruction, which is indicated for nonviable labral tissue.
Key Findings
- Labral repair remains the preferred treatment for viable tissue and offers consistently good outcomes.
- Labral reconstruction (segmental or circumferential) is effective when the native labrum is irreparable.
- Short-term outcomes for reconstruction are promising, but long-term comparative data are limited.
Conclusions
While labral repair is favored when feasible, labral reconstruction provides a reliable option in cases of irreparable labral damage, preserving joint function and reducing symptoms.
What Does This Mean for Providers?
- Carefully assess labral viability intraoperatively to determine if repair or reconstruction is more appropriate.
- Consider circumferential reconstruction in cases with extensive damage or previous failed repairs.
- Counsel patients regarding recovery expectations and the potential for comparable outcomes between techniques when appropriately indicated.
- Long-term studies are still needed to guide optimal technique selection.