Knotless Labral Repair Using the Inversion Technique in Hip Arthroscopy

Abstract

Background: Hip arthroscopy is technically demanding with a steep learning curve, and labral repair is an important component of the surgical treatment of femoroacetabular impingement (FAI) syndrome. As hip arthroscopy indications and techniques are evolving, it is important to remain focused on teaching techniques that are easily mastered and have a measurable benefit to patient outcomes. Indications: Patients with FAI syndrome and labral tear who have failed conservative treatment may benefit from hip arthroscopy, labral repair, and femoroplasty. Technique Description: Labral repair is an essential component of the surgical treatment of FAI syndrome. The hip is accessed in standard fashion, and multiple knotless anchors are used for labral repair. Repair sutures are passed around the labrum in an inverted fashion. This inversion technique ensures the labrum is not everted away from the acetabular rim and that the final position of the labrum will restore a good suction seal on the femoral head. Femoroplasty and capsule closure are always performed. Results: Patients can reliably expect improvements in hip pain and function. A cohort of 62 patients was investigated, and these patients demonstrated significant improvement in multiple patient-reported outcomes related to physical function, activity, and pain at 2 years after hip arthroscopy. Forty-seven percent stated they felt “completely better” at 2 years postoperatively. Discussion/Conclusion: Good hip arthroscopy technique in the proper patient can yield excellent results. The inversion labral repair technique reliably restores the suction seal and prevents eversion of the labrum to preserve normal function. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.