[Labral lesions in femoroacetabular impingement syndrome: evidence-based treatment].

Abstract

Background: The acetabular labrum and the adjacent rim cartilage are the primary targets of primary or secondary degeneration processes in the hip joint. Currently, femoroacetabular impingement syndrome (FAIS) is considered the main mechanical pathology leading to chondrolabral damage. The treatment options for labrum tears range from a debridement/resection, repair to augmentation or transplantation.

Aim: Description of surgical treatment options for pathologic changes of the acetabulare labrum and their results with a focus on FAIS.

Materials and methods: A literature search was performed on https://pubmed.ncbi.nlm.nih.gov using the following key words: hip, labrum, therapy, resection, repair, augmentation, reconstruction.

Results: The different surgical procedures as labrum therapy reduce pain and increase the joint function. Labral repair, augmentation, and reconstruction tend to have better results compared to resection but are associated with a higher rate of postoperative intraarticular adhesions.

Discussion: In addition to reducing pain and improving function, the goal of surgical treatment of labrum lesions should be to maintain the functions of the labrum. The labrum should be preserved, in cases of adequate tissue quality and width. In the setting of resective procedures, the resection should be limited to the unstable parts of the labrum. The results of labral augmentation and reconstruction are promising, allowing these procedures to be considered for patients with ongoing symptoms in the revision situation with labral defects or an insufficient residual labrum.