APEX Hip Enhancing Clinical Expertise and Proficiency (November 2023)-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's presentation focuses on specialized techniques for managing hip labral pathology, emphasizing labral preservation to maintain the hip's fluid seal and improve outcomes. Key pearls include precise anchor placement near the acetabular rim and use of distal portals for safer, more effective repairs. Labral ossific fragments are best excised with a burr to preserve labrum integrity. In cases of non-ossified or ossified rim overcoverage, tailored approaches like focal labral takedown or extensive rim resection with labral repair or reconstruction are recommended. Labral reconstruction is particularly valuable in revision surgeries, irreparable labra, or ossified rims, with graft choices including allografts like tibialis anterior and autografts such as IT band. Outcomes favor labral repair over excision, showing better long-term survivorship and function. While reconstruction shows promise, especially in revision cases, further research is needed to clarify its role and cost-effectiveness in primary procedures. Overall, preserving or reconstructing the labrum optimizes hip mechanics and clinical outcomes.

Asset Caption

Christopher Larson, M.D.

Keywords

hip labral pathology

labral preservation

anchor placement

labral reconstruction

hip mechanics