Surgical Advancements in Hip Arthroscopy and FAI Syndrome: Indications and Technique for Labral Reconstruction of the Hip

The importance of maintaining labral integrity has been a large focus of the recent literature. Loss of the hip suction seal from partial labral resection can increase intra-articular chondral contact pressures, which may predispose the joint to accelerated progression of hip osteoarthritis. The acetabular labrum is a fibrocartilaginous structure located along the rim of the acetabulum, or socket of the hip joint. The decision for management of labral injuries during hip arthroscopy presents as a difficult challenge. In particular, there has been much recent debate whether arthroscopic labral repair or labral reconstruction is indicated to treat labral pathology during the index procedure. The benefits of postfree distraction include negating the risk of iatrogenic perineal soft-tissue compression and pudendal nerve palsy observed with a perineal post, while achieving excellent distraction with only Trendelenburg’s positioning. Entry into the hip joint is achieved through the standard proximal anterolateral (PAL) portal using fluoroscopy and the operative leg under traction.