Editorial Commentary: Confirming Intuitive Thoughts in Hip Preservation
In a biomechanical laboratory study of 63 bovine hip labra examining suture configuration, passer size, and radiofrequency treatment, superior biomechanical properties were found for vertical and oblique sutures compared with horizontal sutures, smaller puncture holes were better compared with large bore holes in the labra, and radiofrequency strengthened labra only when horizontal suture configuration was used. The authors appropriately acknowledge that suture anchor type, presence or absence of knots, and bone quality based on patient demographics and considering various regions of the acetabular rim are additional important factors. Although the authors wisely advocate caution in extrapolation to in vivo behavior, this study represents an important addition to our understanding of the importance of suture configuration in labral repair in the hip. Given the findings of this study and the present state of the art, the current winning formula appears to be labral base refixation with vertical or oblique mattress configuration, performed with small diameter suture passage devices.