IC 04-2025 Arthroscopic Hip Preservation: Labral Treatments, Outcomes, and the Future of Arthroscopy (CME)-IC 04-2025 Arthroscopic Hip Preservation: Labral Treatments, Outcomes, and the Future of Arthroscopy (CME)

Video Transcription

Video Summary

The panel discussion on labral injuries in hip arthroscopy highlighted the evolution of diagnosis and treatment options from debridement through repair, augmentation, and reconstruction. Labral tears are complex and vary in tissue quality, size, degeneration, and location, requiring nuanced approaches. The group emphasized the importance of assessing tissue reparability—sufficient healthy tissue favors repair, while irreparable or degenerative labrums often require augmentation or reconstruction.<br /><br />Debridement, historically common, is now less favored except for minimal trimming of damaged tissue; modern evidence suggests labral repair or reconstruction generally leads to better outcomes. Repair aims to restore the suction seal and maintain joint stability, with technique and anchor choice tailored to anatomy and surgeon preference. Reconstruction, using autograft or allograft tissue, is reserved for irreparable labra, showing good long-term patient satisfaction and durability, especially when cartilage is preserved. Augmentation preserves remaining native labrum, supporting joint congruency and function.<br /><br />Outcomes vary with severity and labral quality, with degenerative and complex tears having worse results than mild, non-degenerated tears. Hypoplastic labrums pose challenges, with some data suggesting repair and reconstruction yield similar outcomes. Future directions include improved diagnostics focusing on dynamic imaging, AI-assisted diagnosis, and biologic augmentation such as BMAC to enhance healing. Surgical technology advances, including smaller anchors, improved suture management, and possibly robotics, promise to improve precision.<br /><br />Panelists noted that while reconstructions are a powerful tool, their use remains limited and should be balanced against risks like overuse or capsular compromise. Case studies were presented to illustrate decision-making based on tissue quality, injury complexity, and patient factors—highlighting the importance of individualized treatment. Ultimately, optimal labral treatment depends on careful patient and tissue assessment, aiming to preserve or restore native labral function for better hip outcomes.

Keywords

labral injuries

hip arthroscopy

labral repair

labral reconstruction

debridement

augmentation

tissue reparability

surgical techniques

diagnostic imaging

biologic augmentation