Enhancing Labral Healing in Arthroscopic Hip Surgery: The Marrow Venting Technique
Author(s): Kahana-Rojkind AH, Rodriguez JD, Sikligar D, McCarroll TR, Quesada-Jimenez R, Domb BG
Background
The acetabular labrum is essential for hip joint stability, fluid pressurization, and load distribution. Conventional labral repair often involves acetabular rim trimming and capsular elevation to enhance healing conditions. However, in select patient populations—particularly those with borderline dysplasia—such maneuvers may compromise joint stability and exacerbate instability. As a result, biologic augmentation techniques are gaining interest to improve healing while preserving bone and soft tissue structures.
Methods
This technical report describes a minimally invasive, arthroscopic marrow venting technique that enhances biological healing during labral repair by:
- Micro-drilling into the acetabular rim to access bone marrow elements.
- Stimulating a local regenerative response through the release of stem cells and growth factors.
- Facilitating labral integration and restoration of the suction seal—without requiring rim trimming or capsular elevation.
Key Advantages
- Preserves acetabular bone stock and joint capsule integrity, which is especially valuable in patients with hip dysplasia or borderline morphology.
- Biologic stimulation through marrow access may enhance healing quality and rate.
- Reduces risk of iatrogenic instability often associated with aggressive debridement or bone removal.
- Fully arthroscopic, easily integrated into standard labral repair workflows.
Conclusion
The marrow venting technique represents a biologically driven, tissue-sparing alternative to conventional labral repair methods. It may be particularly beneficial in patients at higher risk for postoperative instability or where preserving hip architecture is critical to long-term success.
What Does This Mean for Providers?
- Consider marrow venting as an adjunct in labral repairs where traditional bone modification is contraindicated or suboptimal—particularly in borderline dysplastic hips or in athletes requiring stability preservation.
- This technique may provide enhanced biologic healing without sacrificing joint integrity, making it a valuable addition to the hip preservation surgeon’s toolkit.
- Providers should recognize the potential for improved outcomes and reduced risk of instability, especially when working in anatomically constrained or stability-sensitive patients.
- Implementation requires only minor adjustments to standard arthroscopic protocols, making it technically accessible.