Strategies in managing the labrum
The acetabular labrum plays a vital role in normal biomechanics of the hip joint. Both nociceptive and proprioceptive fibers are present in the labrum and their presence determines the rationale behind surgical labral treatments. In patients with femoroacetabular impingement (FAI) syndrome, a variety of labral injuries are observed. These may be the source of significant motion- and position-related hip and/or groin pain. However, there is a high prevalence of asymptomatic labral tear in the general and athletic population. Non-surgical treatment for symptomatic individuals includes education, activity modification, physical therapy, non-opioid oral medications, and injections. In the event of non-surgical treatment failure in non-arthritic and non-dysplastic individuals, surgical treatment includes labral repair and correction of cam, pincer, and subspine morphologies, and capsular management. Labral reconstruction is usually a revision procedure. However, in select primary cases (ossified labrum, global overcoverage pincer, irreparable tear), a reconstruction (or debridement) may be performed.