Debridement versus refixation of the acetabular labrum in patients with hip pain

A review of the literature and a quantitative analysis
Haddad B, Konan S, Haddad FS
From University College Hospital, London, UK
In this study the authors carried out a review of the current literature in order to compare the results of surgical repair against debridement of a lesion of the labrum of the acetabulum. Twenty-eight studies were identified and included in the review, covering a total of 1,631 hips in 1,609 patients. Of these studies, 12 reported a mean rate of good results of the order of 82% for labral debridement. Of the 16 studies that reported a combination of labral debridement and labral refixation, five reported comparable results for the two methods, four reported better results with labral refixation, and one study reported no substantial difference in the results. Because of the heterogeneity of the studies it was not possible to carry out a meta-analysis or to draw firm conclusions.
The authors concluded that it seems reasonable, during hip arthroscopy, to repair an unstable tear in a labrum of good quality with good healing potential, in order to preserve its normal function. A degenerate labrum, on the other hand, can be a source of symptoms from the hip, and preserving it may result in persistent pain and, in addition, in the risk of failed refixation. The results of the present study therefore do not support refixation for all labral tears.