Labral Resection or Preservation During FAI Treatment? A Systematic Review.

Abstract

Open and arthroscopic treatment of femoroacetabular impingement and resultant labral pathology has increased significantly over the past decade. Although the functional importance of the labrum and the labral seal has been established in biomechanical studies, good clinical results have been reported for both labral debridement and labral refixation. The purpose of this paper is to summarize existing literature on the surgical treatment of labral pathology to provide treatment recommendations and direct future research. A systematic review was performed with the following research question in mind: Does preservation of the hip labrum improve outcomes as compared to labral debridement for the treatment of labral pathology? The MEDLINE database was searched for level I, II, or III articles in English or German comparing labral debridement to labral refixation. Five studies were included in the analysis. Good short-term results were reported for both groups. Three out of five papers report improved outcomes after labral refixation as compared to labral debridement. In short-term follow-up, labral refixation appears to have slightly better outcomes than labral debridement. Studies with prospectively defined cohorts and longer follow-up are, however, necessary to provide definitive recommendations for labral treatment.