Labral Tears of the Hip

The acetabular labrum is instrumental in maintaining the suction seal of the hip and consequently fundamental for synovial fluid retention and distribution, load dispersion, and hip joint stability. Labral tears represent the most common indication for hip arthroscopy, but seldom occur in isolation. Trauma, dysplasia, and, most commonly, femoroacetabular impingement (FAI) account for the majority of cases. Patients with labral tears usually complain of groin pain and present with restricted rotational range of motion and positive anterior impingement test upon physical examination. Imaging in the form of radiographs and MRI, in the context of clinical suspicion, provides diagnostic confirmation of labral tears, aside from qualitative and quantitative assessment of underlying morphologic abnormalities. The first line of treatment is typically non-operative, combining rest, anti-inflammatories, physical therapy, and possibly intra-articular injections. Surgical treatment with hip arthroscopy is primarily indicated after failed conservative treatment; other indications include unacceptable functional limitations or significant morphological predisposing abnormalities. Robust literature currently demonstrates clear biomechanical and clinical benefits to repairing labral defects over the previous standard of labral debridement, which ultimately results in superior patient-reported outcomes and return to sports rates, along with prevention of degenerative phenomena.