AANA Hip Arthroscopy - September 2024-Continuum of Labral Management_ My Algorithm for Debridement, Repair, Augment and Reconstruction

Continuum of Labral Management_ My Algorithm for Debridement, Repair, Augment and Reconstruction

Video Transcription

Video Summary

Dr. Christopher Larson discusses advanced strategies for labral management, reconstruction, and outcomes in hip surgery. Key points include the importance of preserving the labral seal by carefully placing anchors near the acetabular rim and avoiding labral takedown when possible. He emphasizes using distal portals for safer anchor placement and intraoperative fluoroscopy for accuracy. For labral ossific fragments, burr resection is preferred to preserve labrum. Managing global or focal overcoverage involves selective rim resections and labral repairs or takedowns. Labral reconstruction is highlighted mainly for revision cases or irreparable labra, with graft options including allografts like tibialis anterior and autografts. Larson details surgical techniques, graft preparation, and emphasizes restoring osseous anatomy to protect repairs. Outcome data favors labral preservation over excision, with reconstruction being effective particularly in revisions. Systematic reviews show both autograft and allograft reconstructions to have similar success rates. He calls for further research on long-term outcomes and costs of primary labral reconstruction.

Keywords

labral management

hip surgery

labral reconstruction

anchor placement

outcomes