title: Debridement versus re-attachment of acetabular labral tears: A review of the literature and quantitative analysis.
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.
authors.affiliation: University College London Hospital, 235 Euston Road, London NW1 2BU, UK.
authors.forename: B
authors.initials: B
authors.lastname: Haddad
authors.forename: S
authors.initials: S
authors.lastname: Konan
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D057925:Femoracetabular Impingement / Q000453:epidemiology / Q000601:surgery; D025981:Hip Injuries / Q000601:surgery*; D006801:Humans; D015995:Prevalence; D016896:Treatment Outcome
keywords: Comparison; Debridement; Hip arthroscopy; Labral tear; Refixation; Review