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Graft Options in Hip Labral Reconstruction

  • Outcomes Research in Orthopedics (O Ayeni, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

The last decade has seen a boom in hip arthroscopy with refined indications. Improved understanding of pathoanatomy and disease progression has allowed for the development of advanced techniques. Labral reconstruction has been developed to substitute a non-functional or absent labrum. It has become an important technique in the armamentarium of high-volume arthroscopic hip surgeons.

Recent Findings

Basic science studies have improved understanding of hip biomechanics in the presence and absence of a labrum with a labral reconstruction allowing for reconstitution of normalcy. Current techniques have shown success with autograft and allograft tissue options. While autograft tissue allows for easy access intra-operatively and maintains patient biology, donor site morbidity is possible. Allografts negate donor site morbidity and allow for an abundance of tissue but can be resource-intensive and face availability concerns. Recent studies support outcomes of labral reconstructions using both autograft and allograft. Promising results have also allowed for performing labral reconstruction in a primary setting.

Summary

Labral reconstruction can be successfully performed using both autograft and allograft. Patient biology should be respected, and native hip biomechanics restored. The literature is plentiful for appropriate surgical decision-making allowing the surgeon with multiple graft choices depending on training, experience, and resources.

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Authors and Affiliations

  1. Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada

    Parth Lodhia, Mark O. McConkey & Jordan M. Leith

  2. Fraser Orthopaedic Institute, 403-233 Nelson’s Crescent, New Westminster, BC, V3L 0E4, Canada

    Parth Lodhia

  3. Pacific Orthopaedics and Sports Medicine, North Vancouver, BC, Canada

    Mark O. McConkey

  4. Footbridge Centre for Integrated Orthopaedic Care, Vancouver, BC, Canada

    Jordan M. Leith

  5. Kerlan-Jobe Institute, Los Angeles, USA

    David R. Maldonado

  6. Orthosports North Harbour, Auckland, New Zealand

    Matthew J. Brick

  7. American Hip Institute Research Foundation, Des Plaines, IL, USA

    Benjamin G. Domb

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Parth Lodhia has nothing to disclose.

Mark O. McConkey has nothing to disclose.

Jordan M. Leith has nothing to disclose.

David R. Maldonado has nothing to disclose.

Matthew J. Brick reports personal fees from Stryker, other from Arthrex, outside the submitted work.

Benjamin G. Domb is the Medical Director of Hip Preservation at St. Alexius Medical Center, the Clinical Instructor at the University of Illinois College of Medicine; is a board member for the American Hip Institute Research Foundation, AANA Learning Center Committee, the Journal of Hip Preservation Surgery, the Journal of Arthroscopy; and has had ownership interests in the American Hip Institute, Hinsdale Orthopedic Associates, Hinsdale Orthopedic Imaging, SCD#3, North Shore Surgical Suites, and Munster Specialty Surgery Center.

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Lodhia, P., McConkey, M.O., Leith, J.M. et al. Graft Options in Hip Labral Reconstruction. Curr Rev Musculoskelet Med 14, 16–26 (2021). https://doi.org/10.1007/s12178-020-09690-4

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