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A Probing Device for Quantitatively Measuring the Mechanical Properties of Soft Tissues during Arthroscopy
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The biomechanical case for labral débridement
1Department of Orthopaedic Surgery, William Beaumont Hospital, 3535 W Thirteen Mile Road, Suite 744, Royal Oak, MI 48073, USA. zaltzira@gmail.com
Clinical Orthopaedics and Related Research
|June 30, 2012
Summary
Routine labral repair for hip impingement is not supported by current evidence. While some studies show benefits with acetabular rim trimming, data on restoring normal function or altering FAI progression is lacking.
Area of Science:
- Orthopedic surgery
- Hip biomechanics
- Regenerative medicine
Background:
- Labral repair is common for hip pain, aiming to restore seal function and improve outcomes.
- Evidence supporting routine labral repair alongside acetabular rim trimming is limited.
- The necessity of labral repair for all symptomatic labral damage remains unclear.
Purpose of the Study:
- To determine if labral repair restores histologic structure, permeability, hydrodynamics, load transfer, and kinematics.
- To assess if labral repair favorably impacts femoroacetabular impingement (FAI) or labral degeneration.
Main Methods:
- Systematic literature search for acetabular labrum research.
- Review of 52 full-text articles on labral biology, biomechanics, and clinical outcomes.
- Analysis of studies concerning labral repair versus resection.
Main Results:
- Clinical studies suggest benefits of labral repair with acetabular rim trimming.
- Limited data exists to support or refute routine labral repair for FAI.
- The effect of labral repair on the natural course of FAI is unknown.
Conclusions:
- Routine labral repair is not supported due to low likelihood of restoring normal tissue characteristics.
- Mechanical data suggests minimal negative consequences from minor labral resections.
- Labral débridement may be a more appropriate approach than routine repair.