Decision Making for Labral Treatment in the Hip: Repair Versus Débridement Versus Reconstruction
Authors: Domb BG, Hartigan DE, Perets I
Journal: J Am Acad Orthop Surg. 2017 Mar;25(3):e53–e62
Purpose
To guide evidence-based decision-making in labral tear management through comparison of labral repair, debridement, and reconstruction.
Methods
Comprehensive review of biomechanical and clinical literature on labral function, degeneration, and surgical techniques.
Key Findings
- Labral repair is preferred when viable tissue remains, as it restores suction seal and joint stability.
- Debridement is reserved for nonviable or degenerative labral tissue.
- Reconstruction is beneficial in revision cases or segmental defects.
Conclusions
A treatment algorithm based on tissue quality, tear pattern, and patient-specific factors can optimize functional outcomes and delay OA progression.
What Does This Mean for Providers?
- Prioritize labral preservation when possible to maintain native joint function.
- Tailor treatment choice based on intraoperative findings and preoperative imaging.
- Educate patients on the rationale for repair vs. reconstruction, especially in revision settings.