http://www.bjj.boneandjoint.org.uk/content/96-B/1/24.abstract

Debridement versus re-attachment of acetabular labral tears

A review of the literature and quantitative analysis

1. B. Haddad, MRCS, Registrar in Trauma and Orthopaedics1 ; 
2. S. Konan, MBBS, MD(Res), MRCS, FRCS(Tr & Orth), Registrar in Trauma and Orthopaedics1 ; and 
3. F. S. Haddad, MBBS, MD(Res), MCh(Orth), FRCS(Tr & Orth), FFSEM, Consultant orthopaedic Surgeon, Professor in Trauma and Orthopaedics1 

+Author Affiliations

1. 1University College London Hospital, 235 Euston Road, London NW1 2BU, UK.

1. Correspondence should be sent to Mr B. Haddad; e-mail:behrooz.haddad@gmail.com

Abstract

We have reviewed the current literature to compare the results of surgery aimed to repair or debride a damaged acetabular labrum. We identified 28 studies to be included in the review containing a total of 1631 hips in 1609 patients. Of these studies 12 reported a mean rate of good results of 82% (from 67% to 100%) for labral debridement. Of the 16 studies that reported a combination of debridement and re-attachment, five reported a comparative outcome for the two methods, four reported better results with re-attachment and one study did not find any significant difference in outcomes. Due to the heterogeneity of the studies it was not possible to perform a meta-analysis or draw accurate conclusions. Confounding factors in the studies include selection bias, use of historical controls and high rates of loss of follow-up.

It seems logical to repair an unstable tear in a good quality labrum with good potential to heal in order potentially to preserve its physiological function. A degenerative labrum on the other hand may be the source of discomfort and its preservation may result in persistent pain and the added risk of failure of re-attachment. The results of the present study do not support routine refixation for all labral tears.

Cite this article: Bone Joint J 2014;96-B:24–30.

Footnotes

• No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
  This article was primary edited by D. Rowley and first-proof edited by J. Scott.
• Supplementary material. Four tables, giving the details of i) the prevalence of signs and symptoms in all studies, ii) the location of labral tears and rehabilitation protocols imposed, iii) the studies describing results of debridement and iv) the studies reporting results of labral re-attachment, are available alongside the electronic version of this article on our website www.bjj.boneandjoint.org.uk

• Received May 14, 2013.
• Accepted September 11, 2013.

• ©2014 The British Editorial Society of Bone & Joint Surgery