Acetabular Labral Preservation: Surgical Techniques, Indications, and Early Outcomes

During the last decade, improvements in arthroscopic instrumentation, techniques, and radiographic imaging have fostered a growing awareness of hip pathology, particularly as it pertains to the acetabular labrum. This structure plays a key function in hip stability, joint lubrication, and pressure distribution. Attenuation or disruption of the labrum may result in hip pain and dysfunction. Treatment options addressing tears of the labrum include nonoperative and open versus arthroscopic surgical techniques. Much like treatment of the meniscus of the knee, our philosophic approach and arthroscopic techniques in addressing labral pathology evolved from resection to repair to replacement. The rationale for this evolution is that labral preservation will provide the hip joint with a superior mechanical environment and more normal function, which will prevent (or at least postpone) osteoarthritis. This article discusses the pathoetiology of labral tears and current arthroscopic techniques and indications for managing these injuries, including labral debridement, repair, replacement, and reconstruction.