Labral management: An overview

Abstract

The labrum has a dense pattern of nociceptive innervation, and thus, lesions of this structure tend to be quite painful. Labral lesions are by far the most common pathology encountered in the hip and the problem most easily discerned by imaging technology such as MRI or MRA. However, isolated labral tears are uncommon, and the etiology is multifactorial. This chapter details the assessment and management of the damaged labrum and also how this interfaces with the treatment of accompanying pathology. The various etiologies are described with emphasis given to the techniques necessary to correct the causation and how this impacts results and future outcomes. These range from trauma to intrinsic labral disease, synovial-based disorders, and morphologic abnormalities on a spectrum from FAI to dysplasia. There is a spectrum of management available for the damaged labrum ranging from simple debridement, primary repair, refixation in conjunction with bony correction, and labral reconstruction. All aspects are outlined providing a comprehensive strategy for this complex topic.