Update on Evidence-Based Diagnosis and Treatment of Acetabular Labral Tears

Abstract

This paper aims to assess the pathophysiology, diagnosis, and latest evidence-based treatment of acetabular labral tears. The acetabular labrum contributes to the stability of the hip. Labral tears may lead to significant pain and disability, although many are asymptomatic. Imaging and intra-articular injections are often required in addition to standard history and physical examination for accurate diagnosis. Most patients will benefit from initial conservative treatment, but those requiring surgical intervention may have better outcomes with labral repair over debridement. If the labral tear is irreparable, reconstruction is favored. There is still conflicting evidence regarding the efficacy of surgical versus non-surgical treatment likely due to heterogeneity of pathology, patient activity, and lack of long-term follow up. The approach to management of acetabular labral tears starts with confirming the labrum as the primary pain generator. Most patients benefit from initial conservative treatment. Ultimately, the decision for surgical treatment is dependent on correct patient selection. Those patients who are youger, with bony morphologic changes, a higher activity level, an isolated labral tear without significant cartilage degeneration, and good response to intra-articular diagnostic injection will likely have better outcomes with surgical treatment.