Primary Labral Reconstruction in Patients with Femoroacetabular Impingement, Irreparable Labral Tears, and Severe Acetabular Chondral Defects Decreases the Risk of Conversion to Total Hip Arthroplasty: A Pair-Matched Study
Authors: Maldonado DR, Go CC, Laseter JR, Lall AC, Kopscik MR, Domb BG
DOI: 10.1093/jhps/hnz028
Background
Patients with femoroacetabular impingement (FAI) and irreparable labral tears plus severe acetabular cartilage defects are at a high risk of joint degeneration and potential conversion to total hip arthroplasty (THA). This study evaluates whether primary labral reconstruction can lower the risk of THA compared to labral resection.
Methods
A pair-matched cohort of patients with FAI, irreparable labral tears, and severe chondral damage underwent either labral reconstruction (RECON) or labral resection (RESEC). The study compared rates of THA conversion and patient-reported outcomes (pain and function) over time.
Key Findings
- Patients in the RECON group were four times less likely to undergo conversion to THA than those in the RESEC group.
- Labral reconstruction yielded superior long-term preservation of the native hip joint, with improved clinical outcomes.
Conclusions
Primary labral reconstruction in the setting of severe labral and cartilage pathology offers significantly better hip preservation and may delay or prevent progression to THA.
What Does This Mean for Providers?
When treating patients with FAI and advanced labral and chondral pathology, labral reconstruction should be strongly considered over resection. It significantly reduces the risk of early THA conversion and enhances joint preservation—especially valuable in younger or active patients.