Labral Reconstruction: When to Perform and How.

Brian J White,Mackenzie M Herzog

doi:10.3389/fsurg.2015.00027

Abstract

Over the past decade, the understanding of the anatomy and function of the hip joint has continuously evolved, and surgical treatment options for the hip have significantly progressed. Originally, surgical treatment of the hip primarily involved resection of damaged tissue. Procedures that maintain and preserve proper hip anatomy, such as labral repair and femoroacetabular impingement correction, have shown superior results, in terms of pain reduction, increased function, and ability to return to activities. Labral reconstruction is a treatment option that uses a graft to reconstruct the native labrum. The technique and outcomes of labral reconstruction have been described relatively recently, and labral reconstruction is a cutting edge procedure that has shown promising early outcomes. The aim of this article is to review the current literature on hip labral reconstruction. We will review the indications for labral reconstruction, surgical technique and graft options, and surgical outcomes that have been described to date. Labral reconstruction provides an alternative treatment option for challenging intra-articular hip problems. Labral reconstruction restores the original anatomy of the hip and has the potential to preserve the longevity of the hip joint. This technique is an important tool in the orthopedic surgeon’s arsenal for hip joint treatment and preservation.

Highlights

Hip arthroscopy is a relatively new frontier in orthopedic surgery, with the first documented arthroscopy of the hip performed less than a century ago in 1931 (1, 2)
The understanding of the anatomy and function of the hip has continuously evolved, and surgical treatment options have significantly progressed to include a multitude of different procedures (1, 3)
Labral reconstruction should be considered in cases where the ability to maintain and preserve the native hip anatomy is compromised

Summary

Introduction

Hip arthroscopy is a relatively new frontier in orthopedic surgery, with the first documented arthroscopy of the hip performed less than a century ago in 1931 (1, 2). The understanding of the anatomy and function of the hip has continuously evolved, and surgical treatment options have significantly progressed to include a multitude of different procedures (1, 3). Labral pathology is one of the most common diagnoses among adolescent and adult patients who present for treatment of hip pain (4, 5). The prevalence is not well understood, the understanding of the role of the acetabular labrum to biomechanical functioning of the hip has improved significantly in recent years. Surgical procedures that maintain and preserve proper hip anatomy, such as labral repair (versus labral debridement) and FAI correction, have shown superior results in comparison, in terms of pain reduction, increased function, and ability to return to activities (5, 8–10, 16–19)

Objectives

Findings

Conclusion