Arthroscopic Labral Reconstruction of the Hip: A Decade of Growing Evidence and Technical Evolution

The field of hip arthroscopy has rapidly evolved over the past 2 decades. Originally, surgical treatment of the hip primarily involved resection of damaged tissue. More recently, arthroscopic surgical procedures that aim to preserve and restore the function of the labrum have been advocated and have shown superior results when compared with debridement or excision. Although labral repair has been largely adopted as a standard labral preservation procedure to treat labral tears, continued innovation in hip arthroscopy techniques and tools has paved the way for labral reconstruction as an alternative and even preferable treatment option. As the clinical field has developed and expanded, so too has the availability and quality of evidence on indications, treatments, and outcomes of hip arthroscopy procedures. The purpose of this manuscript is to review the current literature on indications, arthroscopic technique, and outcomes of arthroscopic acetabular labral reconstruction and provide the lead author's experience with arthroscopic labral reconstruction over the past decade. A growing body of evidence supports the potential to achieve positive patient-reported outcomes and low revision rates with labral reconstruction across different indications. These promising outcomes across a wide variety of settings and pathologies suggest that labral reconstruction can effectively increase function and decrease pain, making it an important hip preservation tool for the hip arthroscopist.