What is labral reconstruction surgery?
Labral injury is a common result of femoroacetabular impingement (FAI) deformity as abnormal bony contact impinges the soft tissue and leads to pinching and tearing of the labrum. The labrum is a very strong fibrocartilage structure that lines the hip socket and provides stability to the hip joint by creating a suction seal. Consequently, damage to the labrum results in destabilization of the hip, restricted motion, and increased weakness. Labral reconstruction surgery is a relatively new procedure that replaces the damaged part of the labrum with a graft (also known as tissue from another part of the body or from a donor) in order to regain stability and normal function of the hip joint. The major difference between labral repair and reconstruction is that repair consists of reattaching the torn labrum to the hip socket; whereas reconstruction involves replacing a segment or the entire native labrum.
Labral reconstruction can be performed as a partial or full labrum reconstruction. A partial reconstruction preserves the healthy part of the labrum and replaces only the damaged segment. A full reconstruction involves replacing the entire native labrum with a graft. The decision to perform one over the other is based on the patient’s unique characteristics and surgeon’s preference.
Who is a good candidate for labral reconstruction?
Labral reconstruction is indicated in patients with symptomatic labral damage if labral repair is not an option (irreparable labrum). This is when there is either too much or too little native labral tissue available to optimize healing with a repair. In cases with too much labral tissue, the excess tissue may interfere with healing, whereas, too little native labral tissue results in the inability to create a suction seal between the ball and socket.
What does the procedure entail?
Hip labral reconstruction is performed arthroscopically. This is a minimally invasive procedure that utilizes small incisions with thin instruments and a small camera to see inside the joint. Studies have shown there are less complications with arthroscopic labral reconstruction than open surgery. The damaged segment of the labrum is removed and measured so that the graft size is prepared appropriately. A new graft the size of the defect is attached to the rim of the hip socket and to the healthy segment of the native labrum. The surgeon will test the new graft and ensure there is a continuous seal between the graft and femoral head.