Arthroscopic Hip Labral Preservation Combined With Bony Correction and Capsular Closure Results in Improved Patient Outcomes

Abstract

Hip labral reconstruction aims to replace an irreparable or insufficient labrum with the goal of restoring the native function of the labrum and thus contribute to hip preservation. Multiple studies have reported success and improved outcomes with labral reconstruction both in primary and revision settings. The function of the labrum includes providing additional soft tissue coverage of the femoral head, and contributing to regulation of fluid dynamics within the hip joint through the "suction seal." Labral tears and insufficiency alter hip joint biomechanics which could result in hip microinstability and joint degeneration. Yet, while labral reconstruction is better than a labral deficient state, labral reconstruction does not restore native hip biomechanics when compared to the native intact labrum. However, concomitant procedures to address bony morphology, hip capsule, cartilage, and adhesions in the revision setting, are frequently performed at the time of labral reconstruction, making the true impact of labral reconstruction unknown. Therefore, the labrum should be considered as one of many variables when evaluating individuals with hip pain, and hip arthroscopy surgeons should ensure that appropriate patient selection and additional pathology is adequately addressed in the primary and revision settings.