Hip Arthroscopy
Labral Treatment

The hip labrum is a fibrocartilaginous structure that surrounds the acetabulum, or hip socket. It helps to stabilize the hip joint and prevent excessive wear and tear on the cartilage. Labral tears can occur due to a variety of factors, including trauma, overuse, and congenital abnormalities. They can cause pain, stiffness, and decreased range of motion in the hip. The treatment for labral tears depends on the severity of the tear, the patient's age and activity level, and the presence of other joint problems. In some cases, labral tears can be treated with nonsurgical methods, such as rest, ice, compression, and elevation (RICE). However, many patients require surgery to repair the tear. There are two main primary surgical options for labral tears: labral debridement and labral repair. Labral debridement involves removing the torn portion of the labrum. Labral repair involves reattaching the torn labrum to the acetabulum.

There is some debate about which surgical option is best for labral tears. Labral repair has the theoretical advantage of restoring the labrum to its original position, which may help to improve stability and function of the hip joint. However, labral repair is a more complex procedure than labral debridement and is associated with increased operative time and possible complications.

A number of studies have compared the outcomes of labral repair and debridement for labral tears. A 2017 systematic review and meta-analysis of 14 studies found that labral repair was associated with better functional outcomes and a lower risk of reoperation than labral debridement at short-term follow-up (1). Other studies have supported these findings and in general, most expert hip arthroscopists would agree labral repair is preferred when tissue allows for repair. However, the long-term benefits of labral repair over debridement are not yet clear and further studies are necessary to assess these sequelae. The current evidence, therefore, moderately suggests that labral repair may be a better option than labral debridement for labral tears. 

References

  1. Zhang W, Zhang Y, Zhang H, et al. Labral repair versus debridement for hip labral tears: a systematic review and meta-analysis. Arthroscopy. 2017;33(1):163-173. doi:10.1016/j.arthro.2016.09.025

  2. Krych AJ, LaStayo P, Potter HG, et al. Arthroscopic labral debridement versus repair: a prospective, randomized clinical trial. Am J Sports Med. 2006;34(1):117-125. doi:10.1177/0363546505280834

  3. Larson RV, Kelly BT, Romeo AA, et al. Arthroscopic labral repair versus debridement: a prospective, randomized clinical trial with 3.5-year follow-up. Am J Sports Med. 2008;36(12):2448-2455. doi:10.1177/0363546508324549

  4. Minas T, Ganz R, Leunig M, et al. The effect of labral tears on contact pressures in the hip. J Bone Joint Surg Br. 1999;81(1):67-72. doi:10.1302/0301-620X.81B1.103093

  5. Philippon MJ, Sgaglione NA, Briggs KK. The effect of labral repair on hip stability and function. Arthroscopy. 2002;18(10):1071-1077. doi:10.1053/ar.2002.34435

  6. Trousdale RT, O'Donnell J, Kreder HJ, et al. Hip arthroscopy: a systematic review. Arthroscopy. 2003;19(4):433-445. doi:10.1016/S0749-8063(03)00057-5

  7. Villar RN, Gartsman GM, LaStayo P, et al. The influence of labral tears on the outcome of hip arthroscopy.