Irreparable Hip Labral Tears and Femoroacetabular Impingement Syndrome: Labral Reconstruction Incorporating the Transverse Acetabular Ligament May Restore the Suction Seal

In the field of hip preservation, arthroscopic labral reconstruction is indicated for acetabular labral deficiency. Controversies regarding hip labral reconstruction abound, including primary versus revision indications, and circumferential versus segmental reconstruction. The goal of hip preservation surgery is to correct bony cam and pincer lesions associated with femoroacetabular impingement, and to restore the soft tissue, including cartilage and the labrum. Ideally, restoration of the chondrolabral junction reestablishes a suction seal, enhancing synovial fluid pressurization, resisting distraction, and enhancing stability. Labral reconstruction incorporating the transverse acetabular ligament may better restore a seal. Both hip labral repair and reconstruction result in excellent, evidence-based short-term outcomes including pain relief, function, and return to sport.