Acetabular Labral Reconstruction Does Not Demonstrate Superior Biomechanical Properties Compared to Labral Repair or Intact Native Labrum but Is Superior to Labral Excision: A Systematic Review of Cadaveric Studies

Acetabular Labral Reconstruction Does Not Demonstrate Superior Biomechanical Properties Compared to Labral Repair or Intact Native Labrum but Is Superior to Labral Excision: A Systematic Review of Cadaveric Studies

Authors: Maldonado DR, Owens JS, George T, Curley AJ, Domb BG

Journal: Arthroscopy, February 2024

DOI: 10.1016/j.arthro.2023.05.025

Objective

Compare biomechanical properties of labral reconstruction with labral repair, intact native labrum, and labral excision using cadaveric models.

Key Findings

• Labral repair and intact native labrum preserve hip stability and suction seal better than labral reconstruction.
• Labral reconstruction is biomechanically superior to labral excision in restoring hip function.
• Repair better prevents fluid efflux, maintaining the hip’s suction seal more effectively than reconstruction.

Conclusion

Labral repair offers superior biomechanical outcomes compared to reconstruction, though reconstruction remains preferable over excision.

What Does This Mean for Providers?

• Prioritize labral repair over reconstruction when feasible to maximize biomechanical restoration and joint stability.
• Use labral reconstruction selectively in cases with irreparable labral tissue, understanding it is biomechanically inferior to repair but better than excision.
• This biomechanical evidence should guide surgical decision-making and patient counseling regarding expected joint stability postoperatively.