The "Rs" of Hip Arthroscopy Management of the Labrum in 2022

Although hip arthroscopy has been around for decades, recent developments in the understanding of hip pathology and surgical technique have led to the evolution of how labral pathology is addressed. Femoroacetabular impingement (FAI) is the primary condition that hip arthroscopy can treat and is described as the mechanical conflict between the femoral neck and acetabulum due to bony morphology. As a result, the labrum endures increased stress and is subject to disruption of its biomechanical properties, which leads to tearing, destabilization of the chondral-labral junction, and loss of the suction seal effect of the hip joint. This review provides an overview of current practices in the diagnosis and treatment of labral pathology. The 4 "R"s of labrum management are described: resect, repair, reconstruct, and replace.