Labral Tears and Femoroacetabular Impingement: Clinical Features and Arthroscopic Management

Context: Labral tears and femoroacetabular impingement (FAI) are increasingly recognized sources of hip pain and disability. FAI has two pathoanatomic phenotypes, Cam and Pincer impingement, and both of these lesions can cause labral tear and its associated symptoms, which can in turn lead to osteoarthritis. Hip arthroscopy is an increasingly popular technique with the potential to address these conditions. Evidence Acquisition: The authors performed a PubMed search on labral tears, FAI, and hip arthroscopy, and further refined the search by pulling relevant citations from the retrieved articles. Evidence Synthesis: Advances in hip arthroscopic techniques have made it possible to perform osteoplasty to treat the source of FAI and to perform labral repair. These procedures appear to be effective in relieving hip pain. However, randomized trials will be needed to perform a rigorous assessment of the efficacy of these procedures in pain relief. Longterm follow-up will be required to determine whether these surgical approaches reduce the risk of osteoarthritis. Conclusions: Clinicians should be aware of labral tears and FAI as common causes of hip and groin pain and disability. Successfully addressing these conditions with hip arthroscopy requires advanced training and a detailed knowledge of the anatomy of the hip. Results have been favorable, but further study is needed to fully document the outcomes of arthroscopic interventions.