Why Do You Focus on the Acetabular Labral Tear? You Can't See the Forest for the Trees

The advent of higher-quality imaging has brought increased attention to the understanding and implications of commonly observed hip morphology and pathology. Many patients and even physicians like to focus on the presence of an acetabular labral tear when one is present on magnetic resonance imaging, despite the limitations of magnetic resonance imaging in identifying labral tears. Furthermore, recent studies have shown normal variations of the acetabular labrum, as well as a high prevalence of labral tears in both symptomatic and asymptomatic individuals. For patients electing to undergo surgical treatment of a labral tear, addressing the underlying pathology is imperative. Ignoring the primary pathology (e.g., femoroacetabular impingement or hip dysplasia) risks the formation of a new labral tear after initial surgical management. This comprehensive approach ensures that the primary cause of the labral tear is treated, thereby reducing the likelihood of recurrence and improving patient outcomes. Although the labrum is highly innervated, making labral tears a direct cause of hip pain in affected patients, we should not be setting our focus on the labral tear itself. Focusing solely on the labral pathology may set up our patients for failure by overlooking the underlying anatomic issues that precipitate these tears. Addressing the root cause, such as correcting femoroacetabular impingement and/or hip dysplasia, is crucial for effective treatment. By correcting these anatomic factors, we can prevent future labral damage and provide more comprehensive and lasting relief for our patients. Ignoring the primary anatomic issues risks recurrent tears and ongoing pain, highlighting the need for a holistic approach to treatment.