Arthroscopic reconstruction of the acetabular labrum with a fascia lata graft: clinical outcomes at a minimum of one year

The integrity of the labrum of the acetabulum is of the greatest importance for the normal biomechanics of the hip joint. In recent years there has been growing interest in the function of the acetabular labrum and in its significance in the clinical picture of patients with a painful hip.
The acetabular labrum is a fibrocartilaginous structure that runs circumferentially around the rim of the acetabulum, providing the seal of the joint. The current literature holds that this seal in the hip is important for maintaining adequate pressure of the intra-articular fluid and for the formation of a lubricating film within the joint.
Disruption of this seal may therefore be harmful to the overall nutrition of the cartilage and may lead to its early degeneration. In addition, the acetabular labrum increases the stability of the hip by enlarging the contact area between the acetabulum and the femoral head. From the biomechanical point of view too, then, an intact labrum appears to give the hip a kinematic advantage for proper function, and every effort should therefore be made to preserve the labrum during hip arthroscopy.
A recently published study set out to determine the clinical effectiveness of reconstruction of the acetabular labrum using a fascia lata graft. The hypothesis of the study was that labral reconstruction can give good clinical results.
A retrospective study was made of 10 patients who underwent reconstruction of the acetabular labrum with fascia lata between January 2013 and October 2015. Improvement in pain and in the function of the joint, complications and any subsequent operations were assessed. The minimum follow-up was 12 months, with a range of 16 to 36 months.
All the patients reported a subjective improvement compared with their preoperative pain and function. The hip scores were all improved and no radiographic progression to arthritis was seen, while no operation for total hip arthroplasty was recorded in these patients.
The authors concluded that arthroscopic reconstruction of the acetabular labrum with fascia lata is an effective and safe technique that not only gives excellent short-term results but may also potentially prevent continuing degeneration of the articular cartilage, by restoring the seal of the joint in patients with a deficient labrum or one that has been resected.
Source: Rathi R, Mazek J. Arthroscopic Acetabular Labral Reconstruction with Fascia Lata Allograft: Clinical Outcomes at Minimum One-Year Follow-Up. Open Orthop J. 2017 Jul 25;11:554-561.