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Acetabular labral tear

71 citationsUpdated Sep 2026

Overview

Acetabular labral tears are frequently associated with high pelvic incidence, occurring with or without femoroacetabular impingement morphology [4]. In asymptomatic contralateral hips exhibiting femoroacetabular impingement, the incidence of a symptomatic labral tear is 9% over two years of follow-up [5]. While the specific location of the tear does not significantly predict functional or clinical outcomes following hip arthroscopy [2, 3], patients with high pelvic incidence demonstrate significantly inferior patient-reported outcomes relative to those with moderate or low pelvic incidence after arthroscopic treatment [8]. For most patients, labral size does not significantly alter patient outcomes or the need for arthroplasty [104].

Surgical repair of the damaged labro-acetabular complex must satisfy two primary goals: preservation or reconstruction of the labrum when possible, and correction of the precipitating cause of the damage [13]. Arthroscopic treatment for acetabular labral tears without dysplasia or bony impingement lesions yields good short- to midterm results [19]. However, indications for repairing a torn acetabular labrum remain highly variable among hip arthroscopic surgeons [17]. Age over 40 years is not an independent contraindication to arthroscopic repair [15, 22], and surgical intervention may be preferred over physical therapy for patients over 40 with symptomatic tears and limited radiographic arthritis [10].

Current literature suggests that acetabular labral repair may result in superior patient-reported outcomes compared to debridement [6]. Acetabular cartilage damage portends inferior patient-reported outcomes two years after primary labral repair and treatment of femoroacetabular impingement [7]. In hips with moderate or severe labral damage, primary circumferential labral reconstruction is a viable option with promising short-term outcomes [9]. Segmental labral reconstruction provides significant improvement in patient-reported outcomes at minimum five-year follow-up [28], and arthroscopic labral reconstruction is associated with significant improvement and a low incidence of secondary surgery within two years [46]. In one cohort, hips undergoing primary labral repair were more likely to fail treatment than those undergoing labral reconstruction (31% vs 0%, respectively) [45]. Labral reconstruction is indicated for irreparable, symptomatic hip labral tears in patients without osteoarthritis, as it is superior to labral excision [34]. Arthroscopic femoroacetabular impingement correction and labral preservation surgery provide favourable clinical outcomes for patients over 70 years old in the absence of significant osteoarthritis and severe acetabular chondral damage [20]. Matched patients with smaller or larger chondral defects undergoing arthroscopic acetabular microfracture with concomitant treatment for labral tears and femoroacetabular impingement syndrome demonstrated similar improvements at minimum two-year follow-up [11].

Anatomy & Pathophysiology

Labral Anatomy and Physiology

The acetabular labrum is a triangular fibrocartilaginous ring that surrounds the periphery of the acetabulum and inserts firmly on the acetabular rim [23]. It encompasses nearly the entire acetabulum, with the most inferior aspect bridged by the transverse acetabular ligament [47]. Blood supply to the acetabulum is primarily derived from the obturator artery, superior gluteal artery, and inferior gluteal artery [23]. The periphery of the labrum is more vascularized than the articular region [23].

Functionally, the labrum deepens the acetabulum, increases coverage of the femoral head, and contributes to shock absorption, joint lubrication, and pressure distribution [47]. Its most critical role is creating a negative pressure seal with the femoral head to aid joint stability [47]. The labrum also increases hip joint stability and seals the hip to prevent fluid escape [23]. Removal of the labrum shifts the femoral contact point toward the acetabular rim, decreases intra-articular fluid pressurization, and results in a loss of lateral restraint to femoral head motion [47]. Consequently, labral removal increases contact stresses between the articular cartilage of the femoral head and the acetabulum by 92% [47]. Biomechanically, the acetabular labrum acts as the primary hip stabilizer against distraction forces at small displacements of 1–2 mm [71]. In contrast, capsular ligaments provide more rotational restraint to the hip than the acetabular labrum and the ligamentum teres [97].

Tear Morphology and Classification

Seldes et al. described two types of labral injuries: separation of the labrum from its articular attachment and tears in various planes within the substance of the labrum [23]. A morphologic classification based on arthroscopic findings includes radial flap tears, radial fibrillated tears, longitudinal peripheral tears, and unstable tears [23]. Stable tear patterns comprise radial, fibrillated, and longitudinal peripheral tear patterns [47]. Specifically, radial flap tears involve intra-articular free-edge disruption [47]. Radial fibrillated tears are degenerative tears characterized by fibrillated free margins [47]. Longitudinal peripheral tears represent stable labral separations from the acetabular margin [47]. Unstable tears include the bucket-handle tear [47].

Regarding anatomical location, Type 1 labral tears occur at the junction between the fibrocartilaginous labrum and the articular hyaline cartilage [47]. Type 2 labral tears occur in various planes within the substance of the labrum [47]. Anterior labral tears are prevalent in most studies due to their association with femoroacetabular impingement [47].

Pathophysiology and Etiology

Acetabular labral tears rarely occur in the absence of bony abnormalities, with 87% of patients having at least one abnormality detectable on conventional radiographs [12]. Symptomatic labral tears correlate with abnormal hip morphology, as reflected by radiographic measurements of dysplasia and impingement [14]. Abnormal hip morphology may serve as a risk factor for labral tears [14]. Acetabular labral tear is associated with high pelvic incidence with or without femoroacetabular impingement morphology [4].

In femoroacetabular impingement, the acetabular labrum is the first structure to fail due to repetitive impact between the rim and the head and neck junction in pincer type [99]. Labral-chondral separation is more commonly seen with cam type impingement than with femoroacetabular impingement [23]. Conversely, intrasubstance tears are more typical of pincer impingement [23]. In dysplastic hips, labral tears are thought to be a consequence of high shear stresses and subsequent instability attributable to inadequate coverage of the femoral head by the dysplastic acetabulum [99].

Sports requiring significant hip torsion can lead to capsule attenuation and laxity secondary to repetitive microtrauma [47]. This attenuation leads to microinstability, in which the femoral head subluxates anteriorly and rides on the anterior superior labrum [47]. Microinstability can also occur in patients with collagen disorders such as Ehlers-Danlos syndrome, Marfan syndrome, and Down syndrome [47]. Iliopsoas impingement on the anterior hip joint is suggested as an additional mechanism for labral tears [47]. An atypical labral tear pattern occurs on the anterior acetabulum directly beneath where the iliopsoas tendon crosses the hip joint in patients with iliopsoas impingement [47]. Traction injury of sufficient energy to the reflected head of the rectus femoris can tear the labrum in this location [47].

Degenerative labral tears are analogous to degenerative meniscus tears in the knee and are frequently associated with diffuse articular changes in an arthritic joint [47]. These tears are thought to be extremely common in the aging hip and likely occur early in the arthritic process [47]. Between 48% and 95% of labral tears are often associated with damage to the acetabular cartilage as well as the early onset of osteoarthritis [29]. In a study of 436 patients, 73% of those with labral tears or fraying had articular damage, with most of the damage located in the same zone as the labral damage [23]. The severity of chondral damage was greater in patients with labral tears than in patients who had an intact labrum [23]. In the presence of a labral tear, the function to seal the hip is lost and may lead to increased contact pressure, which is thought to have a role in the development of degenerative disease [23].

Male and female patients differ in their hip structure, biomechanics, and operative findings of symptomatic labral tears [21]. The high incidence of acetabular retroversion shows that this anatomic configuration may not differ in frequency between asymptomatic individuals and patients with symptomatic femoroacetabular impingement [38]. 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 [26].

Clinical Presentation

Patients with labral tears typically present with pain, usually groin pain, and mechanical symptoms [23]. Byrd described the C-sign, where patients cup their hand forming a C over the greater trochanter when asked to localize the pain [23]. Pain may be minimal with level walking [23]. Patients usually complain of anterior groin pain that can refer to the gluteal or trochanteric regions [29]. Pain often has an insidious onset that is sharp and can be aggravated by activity such as prolonged standing, sitting, walking, or pivoting [29].

Patients may report mechanical symptoms, such as clicking and catching, as well as groin pain in positions of hip flexion [47]. It is not uncommon to feel pain laterally or posteriorly with anterior labral tears [47]. Pain with prolonged sitting is another common symptom [47]. Physical examination findings can include pain in the provocative position of flexion, adduction, and internal rotation if the tear is anterior [47]. Physical examination findings can include pain in flexion, abduction, and external rotation if the tear is lateral [47]. The most valuable diagnostic sign is a positive response to an intra-articular joint injection that brings complete pain relief, even for a brief period [47].

Classification

Arthroscopic Grading Systems

Beck classification: The Beck classification is the current standard for arthroscopic evaluation of intraarticular disease in femoroacetabular impingement [93]. It demonstrates substantial interobserver reliability for the arthroscopic classification of acetabular rim labrochondral disease [69, 93]. A proposed novel classification with only two disease categories may not adequately characterize the spectrum of intra-articular abnormalities compared to the Beck classification [93].

Haddad classification: The Haddad classification demonstrated the best interobserver reliability for arthroscopic assessment of chondral damage of the hip in a series comparing three different classifications [102].

ALAD and Outerbridge classifications: The Acetabular Labrum Articular Disruption (ALAD) classification and Outerbridge classification have identical descriptions for grades 0 and 1 [91].

Preoperative Imaging-Based Classification

ETD score: The Extension–Thickness–Damage (ETD) score is a pre-operative hip MR arthrography-based classification designed to predict the type of labrum surgery [30]. It is based on three parameters: extension of the damage, thickness of the labrum, and type of damage [30]. In the ETD score, extension of labral damage is divided into four sections: anterior, antero-superior, postero-superior, and posterior [30]. Labral thickness is measured at 10, 12, and 2 o'clock positions to determine tissue amenable to repair [30].

Tear Morphology and Location

Labral tear size correlates significantly with a patient’s duration of THA-free survivorship [83]. After adjusting for relevant covariates, labral tear size is a stronger independent predictor of conversion to total hip arthroplasty than a 10-year increase in age or a 1-unit increase in Tönnis grade [83]. Male patients had a significantly larger mean labral tear size when compared with female patients [83]. The locations predominantly involved with labral tears were different in femoroacetabular impingement and mild dysplastic hips (anterior and anterosuperior zones) compared to severely dysplastic hips (anterosuperior and superior zones) [107]. In a cohort of high-level athletes undergoing bilateral hip arthroscopy, labral tears were the most common intraoperative finding, present in 97.6% of first-side cases and 98.8% of second-side cases [52].

Associated Pathology and Structural Associations

Acetabular labral tears are significantly associated with structural abnormalities of the hip, with 87% of patients having at least one abnormality detectable on conventional radiographs [12]. Damage at the chondrolabral junction was very common in a hip arthroscopy cohort, while isolated defects to the acetabular cartilage or labrum were rare [27]. The incidence of a symptomatic labral tear in asymptomatic contralateral hips with femoroacetabular impingement was 9% during 2 years of followup [5].

Clinical Presentation

Symptoms and Signs

Patients with acetabular labral tears typically present with pain, usually localized to the groin, alongside mechanical symptoms [23]. A torn acetabular labrum is a well-documented source of hip pain and discomfort [14]. The pain often varies in location, intensity, and relation to aggravating activities [48]. Hip or groin pain may be accompanied by mechanical symptoms including clicking, locking, and instability [48]. In some cases, pain remains minimal during level walking [23]. Patients with symptomatic femoroacetabular impingement typically present with an insidious onset of groin pain, limited hip motion, and a significant delay in diagnosis, often following frequent inaccurate prior diagnoses [50].

Physical Examination

On physical examination, patients may exhibit a positive impingement sign of the hip [48]. Gait abnormalities and pain with provocative maneuvers are also common findings [48]. The symptoms and signs of a labral tear are nonspecific, meaning clinical assessment may not allow for a definitive diagnosis initially [48]. History and physical examination have demonstrated only moderate sensitivity and specificity for evaluating labral tears [74]. Consequently, there are few specific clinical symptoms associated with acetabular labral injury, making a diagnosis based solely on clinical findings difficult [35].

Associated Pathology and Risk Factors

Acetabular labral tears are associated with structural abnormalities of the hip, with 87% of patients having at least one abnormality detectable on conventional radiographs [12]. In a study of 436 patients, 73% of those with labral tears or fraying had articular damage [23]. Most articular damage in these patients was located in the same zone as the labral damage [23].

Prevalence in Asymptomatic Populations

Hip labral tears are common on MRI among asymptomatic professional hockey players [58]. Among this population, 20% of patients with hip labral tears on MRI produce symptoms within two years [58]. However, only 6.7% result in missed games within four years due to hip-related pain [58]. More broadly, patients with apparently abnormal imaging findings in asymptomatic hips have a 21% risk of developing symptoms [25].

Diagnostic Evaluation

It is impossible to identify acetabular labral tears directly on plain radiographs [35]. Arthroscopy is considered the gold standard for confirming a labral tear [48]. The orthopaedic investigation of labral pathology increasingly relies on adjuvant magnetic resonance imaging (MRI) evidence of a labral tear prior to proceeding with surgical therapeutic interventions [48].

Magnetic Resonance Imaging: Magnetic resonance arthrography is an excellent positive predictor in diagnosing acetabular labral tears and articular cartilage abnormalities [49]. However, magnetic resonance arthrography has limited sensitivity in diagnosing acetabular labral tears [49]. According to an updated meta-analysis of diagnostic accuracy, 3.0 T MRI is more recommended to detect acetabular labral tears than MR Arthrography [67].

Other Modalities: Ultrasound could be used as a feasible method to evaluate anterosuperior acetabular labral tears due to being inexpensive, relatively quick, noninvasive, and having dynamic evaluation [24]. Computed tomographic arthrography shows reliable validity in the diagnosis of acetabular labral tears [31]. The presence of implanted metal did not affect CT arthrography for the diagnosis of acetabular labrum injury in a case presentation [35].

Investigations

Clinical Presentation and Physical Examination

Patients with acetabular labral tears typically present with groin pain and mechanical symptoms [23]. Pain may be minimal during level walking [23]. The "C-sign," where a patient cups their hand over the greater trochanter to localize pain, is indicative of a labral tear [23]. Patients with symptomatic femoroacetabular impingement typically present with insidious onset of groin pain, limited hip motion, and a significant delay in diagnosis [50]. Symptoms and signs of a labral tear are nonspecific, and clinical assessment may not allow for the definitive diagnosis of a tear to be made initially [48]. Patients may report mechanical symptoms such as clicking, locking, and instability [48]. Physical examination findings for anterior labral tears can include pain in the provocative position of flexion, adduction, and internal rotation [47]. Physical examination findings for lateral labral tears can include pain in flexion, abduction, and external rotation [47]. A positive response to an intra-articular joint injection that brings complete pain relief is the most valuable diagnostic sign for confirming the joint as the source of pain [47].

Imaging Modalities

Plain radiography: Radiography remains the primary screening tool for hip pain [98].

MRI: Direct MR arthrography is critical for evaluating intra-articular pathology such as labral tears due to its superior sensitivity and accuracy compared to nonarthrogram MR [98]. MRI and MRI-arthrogram are useful for identifying labral tears [23]. Magnetic resonance arthrography is an excellent positive predictor in diagnosing acetabular labral tears but has limited sensitivity [49]. Radially reconstructed MERGE MRI may be an alternative to magnetic resonance arthrography for evaluating labrum tears [109]. The dimensions of the hip labrum can be reliably measured using magnetic resonance and computed tomography [56]. Hip labral width less than 1 SD below the mean measured via preoperative MRI was associated with significantly worse functional outcomes after arthroscopic labral repair and treatment of femoroacetabular impingement [44].

CT: CT scan offers greater detail in assessing bony architecture [23]. Computed tomographic arthrography (CTA) shows reliable validity in the diagnosis of acetabular labral tears [31]. The dimensions of the hip labrum can be reliably measured using magnetic resonance and computed tomography [56].

Ultrasound: Ultrasound could be used as a feasible method to evaluate anterosuperior acetabular labral tear due to its advantages of being inexpensive, relatively quick, noninvasive, and having dynamic evaluation [24].

Radiographic and Morphologic Findings

The high incidence of acetabular retroversion determined by the cross-over sign shows that this anatomic configuration may not differ in frequency between asymptomatic individuals and patients with symptomatic femoroacetabular impingement [38].

Preoperative Prognostic Factors

Other Considerations: Patients with a high pelvic incidence exhibit significantly inferior patient-reported outcomes relative to those with moderate and low pelvic incidence following hip arthroscopy to address acetabular labral tears [8]. The presence of apparently abnormal imaging findings in asymptomatic patients is well-known, and patients should be informed that there is a 21% risk of developing symptoms from labral tears [25]. Although common on MRI among asymptomatic professional hockey players, hip labral tears produce symptoms in 20% within two years [58]. Young athletes with limited hip range of motion showed increased progressive degenerative changes on MRI and radiographs compared with matched controls at 5 years [40].

Treatment

Non-Operative

Initial management of acetabular labral tears is typically nonoperative, comprising rest, anti-inflammatory agents, and physical therapy [23]. Patients with symptomatic labral tears can experience functional improvement after a minimum of one year of non-surgical management [62]. Improvement in functional outcome scores has been observed despite persistent pain with 1 year of nonsurgical management for acetabular labral tears with or without femoroacetabular impingement [18]. However, hip arthroscopic surgery is more cost-effective than structured rehabilitation alone, resulting in a lower incidence of symptomatic osteoarthritis in patients from the second to seventh decades without preexisting osteoarthritis [101].

Operative

Indications: Surgical repair of the damaged labro-acetabular complex aims to preserve or reconstruct the labrum when possible and address the precipitating cause of the damage [13]. Arthroscopic treatment emphasizes addressing concurrent causes such as femoroacetabular impingement for good clinical outcomes [1]. Addressing underlying pathology, such as femoroacetabular impingement or hip dysplasia, is imperative for patients electing surgical treatment to reduce the likelihood of recurrence [26]. Failure to address bony dysmorphism that contributes to labral abnormality substantially increases the risk for clinical failure and the need for revision surgery [29]. Indications to repair a torn acetabular labrum are highly variable among hip arthroscopic surgeons, with different surgeons potentially selecting different treatments for the same tear [17].

Surgical Approach / Technique: Surgical strategies should preserve all functional labral tissue, either through selective debridement with preservation or anatomic labral refixation for tears with robust tissue quality and good healing potential [29]. Two main suture configurations are used: a circumferential repair where the suture is looped around the entirety of the labrum, and a labral base repair where the suture is passed through the substance of the labrum [23]. The choice of configuration depends on the quality of the remaining labral tissue [23]. In patients with robust labral tissue, a labral base repair is typically used [23]. When the labrum is significantly frayed, a circumferential repair is chosen to avoid the suture lacerating the remaining labrum [23]. It is essential to maintain labral contact with the femoral head to reestablish the suction seal during repair [23]. Anchors placed too far from the acetabular rim or sutures that are overtightened may evert the labral edge [23]. A retrospective study showed no difference in outcomes between circumferential and labral base suture patterns [23].

Repair vs. Debridement: In patients with femoral acetabular impingement, improvement in Harris Hip scores was greater in the labral refixation group compared to the labral debridement group [23]. Hips that did not show any signs of arthritis treated with labral debridement had a significant increase in Harris Hip Scores that remained significant throughout a 10-year period [23]. Conversely, seven of eight patients with associated arthritis who underwent labral debridement required total hip arthroplasty [23].

Reconstruction: Both hip labral repair and reconstruction result in excellent, evidence-based short-term outcomes including pain relief, function, and return to sport [42]. Early data suggest that labral reconstruction using either autograft or allograft tissue may be a viable solution for patients with ossified labral tissue, severe labral deficiency, or prior labral resections with persistent symptoms [29].

Other Considerations: Hip labral width less than 1 standard deviation below the mean measured via preoperative MRI was associated with significantly worse functional outcomes after arthroscopic labral repair and treatment of femoroacetabular impingement [44]. Labral tear length is independently predictive of patient-reported outcomes after hip arthroscopy for femoroacetabular impingement syndrome, with patients having smaller tears (<2.5 cm) demonstrating better outcomes and a higher likelihood of achieving a minimal clinically important difference at 2-year follow-up [61]. Matched patients with either smaller or larger chondral defects undergoing arthroscopic acetabular microfracture with concomitant treatment for labral tears and femoroacetabular impingement syndrome demonstrated similar improvements at minimum 2-year follow-up [11]. Microfracture alone results in a greater or equivalent reoperation rate and inferior or equivalent patient-reported outcomes compared with other cartilage repair procedures for acetabular chondral lesions in patients with femoroacetabular impingement syndrome [100].

Age and Patient Selection: Hip arthroscopy for the treatment of labral tears and femoroacetabular impingement in patients 50 years old demonstrates statistically significant patient-reported outcome improvements at minimum 5-year follow-up [60]. Arthroscopic femoroacetabular impingement correction and labral preservation surgery provide favourable clinical outcomes for patients over 70 years old in the absence of significant osteoarthritis and severe acetabular chondral damage [20]. Age over 45 is not a contraindication for periacetabular osteotomy or hip arthroscopy if articular cartilage status is normal [89]. At mid- to long-term follow-up, patients who underwent primary hip arthroscopy demonstrated improvement in several patient-reported outcomes [36].

Complications

Risk Factors and Associated Pathology

Failure to address bony dysmorphism that contributes to labral abnormality substantially increases the risk for clinical failure and the need for revision surgery [29]. Ignoring the primary pathology, such as femoroacetabular impingement or hip dysplasia, risks the formation of a new labral tear after initial surgical management [26].

Surgical Outcomes and Failure

Hips that underwent primary labral repair were more likely to fail treatment than hips that underwent labral reconstruction (31% vs 0%, respectively) [45]. Isolated arthroscopic labral debridement for hip labral tears had 45% combined poor results when strictly defining failure as repeat surgery or abnormal hip rating [63].

Iatrogenic and Procedural Factors

Iatrogenic labral punctures did not affect the 1- and 2-year clinical results of patients who sustained these injuries during hip arthroscopy [43].

Long-Term Progression and Conversion

Hip arthroscopic surgery results in a considerably lower incidence of symptomatic osteoarthritis than structured rehabilitation alone in treating symptomatic labral tears of patients in the second to seventh decades of life without pre-existing OA [112].

Recovery

Operative Outcomes: Acetabular labral repair may result in superior patient-reported outcomes compared to debridement [6]. Patients who underwent primary hip arthroscopy demonstrated improvement in several patient-reported outcomes at mid- to long-term follow-up [36]. Improved patient-reported outcomes were observed in all studies at minimum 5-year follow-up, suggesting that labral reconstruction can offer durable results beyond short-term follow-up [55]. Primary labral reconstruction demonstrated favorable outcomes at a minimum 10-year follow-up [59].

Other Considerations: The available evidence reports outcome durability at specific follow-up intervals (minimum 5-year and minimum 10-year) but does not provide specific timelines for light activity, full activity, complete recovery, or rehabilitation protocols. Consequently, no recovery-phase time ranges or functional milestone benchmarks are defined in this section.

Key Evidence

• [Paper] The article describes labral anatomy, clinical presentation, and provides guidelines for arthroscopic treatment of acetabular labral tears, emphasizing the need to address concurrent causes such as femoroacetabular impingement for good clinical outcomes. [1] (10.1016/j.csm.2010.12.006)
• [L3] Acetabular labral tear location was not found to be a significant predictor of functional or clinical outcomes following hip arthroscopy. [2] (10.1177/2325967126s00443)
• [L3] Acetabular labral tear location was not found to be a significant predictor of functional or clinical outcomes after hip arthroscopy. [3] (10.1177/23259671261432671)
• [L3] Acetabular labral tear is associated with high pelvic incidence with or without femoroacetabular impingement morphology. [4] (10.1007/s00167-022-06881-z)
• [L4] The incidence of a symptomatic labral tear in these asymptomatic hips was 9% during 2 years of followup. [5] (10.1097/corr.0000000000000567)
• [L1] Current literature suggests that acetabular labral repair may result in superior patient reported outcomes. [6] (10.1016/j.asmr.2021.06.008)
• [L3] Acetabular cartilage damage portends inferior patient-reported outcomes 2 years after primary labral repair and treatment of femoroacetabular impingement. [7] (10.1016/j.arthro.2022.05.013)
• [L3] Following hip arthroscopy to address acetabular labral tears, patients with a high pelvic incidence exhibit significantly inferior patient-reported outcomes relative to those with moderate and low pelvic incidence. [8] (10.1177/2325967124s00007)
• [L3] Primary circumferential labral reconstruction is a viable treatment option with promising short-term outcomes for hips that demonstrate moderate or severe labral damage. [9] (10.1177/0363546518775425)
• [L1] Results indicate that surgical intervention may be preferred over PT for patients over the age of 40 with symptomatic acetabular labral tears and limited radiographic arthritis. [10] (10.1177/2325967118s00071)
• [L3] Matched patients with either smaller or larger chondral defects undergoing arthroscopic acetabular microfracture with concomitant treatment for labral tears and FAI syndrome demonstrated similar improvements at minimum 2-year follow-up. [11] (10.1016/j.arthro.2019.01.047)
• [L4] The study showed a significant association between acetabular labral tears and structural abnormalities of the hip, with 87% of patients having at least one abnormality detectable on conventional radiographs. [12] (10.1097/01.blo.0000136903.01368.20)
• [L5] Surgical repair of the damaged labro-acetabular complex should satisfy two goals: first, the labrum should be preserved or reconstructed when possible, and second, the precipitating cause of the labro-acetabular damage must be addressed. [13] (10.2106/jbjs.j.01710)
• [L3] [14] (10.1097/01.blo.0000246536.90371.12)
• [L1] Thus, age over 40 years should not be considered a contraindication to arthroscopic acetabular labral repair. [15] (10.1177/0363546521990789)
• [L4] However, different surgeons viewing the same tear arthroscopically may select different treatments, and the indications to repair a torn acetabular labrum are highly variable among hip arthroscopic surgeons. [17] (10.1177/2325967118797324)
• [L4] [18] (10.1177/0363546518814484)
• [L4] Arthroscopic treatment for acetabular labral tears of the hip without dysplasia or bony impingement lesions has good short- to midterm results. [19] (10.1177/0363546511412915)
• [L3] Arthroscopic FAI correction and labral preservation surgery provide favourable clinical outcomes for patients over 70 years old in the absence of significant osteoarthritis and severe acetabular chondral damage. [20] (10.1007/s00167-019-05520-4)
• [L3] Male and female patients differ in their hip structure, biomechanics, and operative findings of symptomatic labral tears. [21] (10.1177/0363546514532226)
• [L1] When surgery is indicated, age 40 years should not be considered an independent contraindication to arthroscopic acetabular labral repair. [22] (10.1177/03635465241263595)
• [L4] With the advantages of being inexpensive, relatively quick, noninvasive, and having dynamic evaluation, ultrasound could be used as a feasible method to evaluate anterosuperior acetabular labral tear. [24] (10.1016/j.arthro.2019.02.052)
• [L5] The presence of apparently abnormal imaging findings in asymptomatic patients is well-known, and while preventive treatment cannot be justified for labral tears in the hip, patients should be informed that there is a 21% risk of developing symptoms. [25] (10.1097/corr.0000000000000606)
• [L5] [26] (10.1016/j.arthro.2024.10.052)
• [L3] Damage at the chondrolabral junction was very common in this hip arthroscopy cohort, while isolated defects to the acetabular cartilage or labrum were rare. [27] (10.1007/s00167-018-4861-2)
• [L3] Hip arthroscopy with segmental labral reconstruction resulted in significant improvement in PROs at minimum 5-year follow-up. [28] (10.1177/0363546518825259)
• [L5] [29] (10.1177/0363546513476281)
• [L4] [30] (10.1007/s00402-019-03112-y)
• [L4] However, CTA shows reliable validity in the diagnosis of acetabular labral tears. [31] (10.1016/j.arthro.2013.07.274)
• [L5] Labral reconstruction should be performed for irreparable, symptomatic hip labral tears in patients without osteoarthritis, as it is superior to labral excision, though direct comparisons with repair are challenging due to distinct clinical indications and surgical heterogeneity. [34] (10.1016/j.arthro.2023.07.003)
• [L4] [35] (10.1016/j.arthro.2007.07.005)
• [L4] At mid- to long-term follow-up, patients who underwent primary hip arthroscopy demonstrated improvement in several PROs. [36] (10.1016/j.arthro.2020.10.001)
• [L4] The high incidence of acetabular retroversion, determined by the COS, shows that this anatomic configuration may not differ in frequency between asymptomatic individuals and patients with symptomatic femoroacetabular impingement (FAI). [38] (10.1302/0301-620x.99b12.37081)
• [L2] At 5 years, young athletes with limited hip range of motion showed increased progressive degenerative changes on MRI and radiographs compared with matched controls. [40] (10.1177/0363546517719460)
• [L5] Both hip labral repair and reconstruction result in excellent, evidence-based short-term outcomes including pain relief, function, and return to sport. [42] (10.1016/j.arthro.2020.08.018)
• [L3] Iatrogenic labral punctures did not affect the 1- and 2-year clinical results of patients who sustained these injuries during hip arthroscopy. [43] (10.1016/j.arthro.2011.01.019)
• [L4] Hip labral width less than 1 SD below the mean measured via preoperative MRI was associated with significantly worse functional outcomes after arthroscopic labral repair and treatment of femoroacetabular impingement. [44] (10.1016/j.arthro.2020.08.006)
• [L3] In this cohort of patients, hips that underwent primary labral repair were more likely to fail treatment than hips that underwent labral reconstruction (31% vs 0%, respectively). [45] (10.1016/j.arthro.2017.08.240)
• [L3] Arthroscopic labral reconstruction is associated with significant improvement in PROs and a low incidence of secondary surgery within 2-year follow-up. [46] (10.1016/j.arthro.2018.09.024)
• [L5] [48] (10.2106/jbjs.j.01722)
• [L3] Although magnetic resonance arthrography is an excellent positive predictor in diagnosing acetabular labral tears and articular cartilage abnormalities, it has limited sensitivity. [49] (10.1097/01.blo.0000150125.34906.7d)
• [L2] Patients with symptomatic femoroacetabular impingement typically present with insidious onset of groin pain, limited hip motion, and a significant delay in diagnosis with frequent inaccurate prior diagnoses. [50] (10.1007/s11999-008-0680-y)
• [L4] [52] (10.1177/0363546519885354)
• [L1] Improved patient-reported outcomes were observed in all studies at minimum 5-year follow-up, suggesting that labral reconstruction can offer durable results beyond short-term follow-up. [55] (10.1016/j.arthro.2023.02.015)
• [L4] The establishment of a gold-standard of measurement on arthroscopy and advanced imaging would aid in clinical decision-making regarding treatment options for patients presenting with a painful hip, particularly those with hypoplastic labra. [56] (10.1007/s00167-020-06330-9)
• [L3] Although common on MRI among asymptomatic professional hockey players, hip labral tears produce symptoms in 20% within two years, but only 6.7% result in missed games within four years due to hip-related pain. [58] (10.1177/2325967113s00057)
• [L2] Primary labral reconstruction demonstrated favorable outcomes at a minimum 10-year follow-up. [59] (10.1177/03635465251392196)
• [L4] Hip arthroscopy for the treatment of labral tears and FAI in patients 50 years old demonstrates statistically significant PRO improvements at minimum 5-year follow-up. [60] (10.1016/j.arthro.2018.05.034)
• [L3] Labral tear length is independently predictive of patient-reported outcomes after hip arthroscopy for FAIS, with patients having smaller tears (<2.5 cm) demonstrating better outcomes and a higher likelihood of achieving a minimal clinically important difference at 2-year follow-up. [61] (10.1177/0363546519831291)
• [L3] Patients with symptomatic labral tears can experience functional improvement after a minimum of one year of non-surgical management. [62] (10.1177/2325967118s00008)
• [L4] Isolated arthroscopic labral debridement for hip labral tears had 45% combined poor results when strictly defining failure as repeat surgery or abnormal hip rating. [63] (10.1007/s00167-014-2872-1)
• [L1] [67] (10.1186/s13018-022-02981-1)
• [L3] The arthroscopic classification of acetabular rim disease with the Beck classification has substantial interobserver reliability. [69] (10.1177/0363546512457157)
• [L5] The acetabular labrum was the primary hip stabilizer to distraction forces at small displacements (1–2 mm). [71] (10.1007/s00167-014-2875-y)
• [L2] [74] (10.1016/j.arthro.2019.09.027)
• [L3] [83] (10.1177/23259671251410207)
• [L5] Age over 45 is not a contraindication for PAO/hip arthroscopy if articular cartilage status is normal. [89] (10.1016/j.arthro.2024.11.074)
• [L3] [91] (10.1016/j.arthro.2017.10.023)
• [L5] The Beck classification represents the current standard for arthroscopic evaluation of intraarticular disease in femoroacetabular impingement, demonstrating substantial interobserver reliability, while the proposed novel classification with only two disease categories may not adequately characterize the spectrum of intra-articular abnormalities. [93] (10.1177/0363546513480110)
• [L5] Each of the capsular ligaments acted as the primary hip rotation restraint somewhere within the complete range of movement, and the ligamentum teres acted as a secondary restraint in high flexion, adduction and external rotation. [97] (10.1302/0301-620x.97b4.34638)
• [Paper] Radiography remains the primary screening tool for hip pain, while direct MR arthrography is critical for evaluating intra-articular pathology such as labral tears and cartilage defects due to its superior sensitivity and accuracy compared to nonarthrogram MR. [98] (10.1016/j.csm.2005.12.009)
• [L4] [99] (10.1097/01.blo.0000144861.11193.17)
• [L2] Based on the available data, microfracture alone results in a greater or equivalent reoperation rate and inferior or equivalent patient-reported outcomes compared with other cartilage repair procedures for acetabular chondral lesions in patients with femoroacetabular impingement syndrome. [100] (10.1016/j.arthro.2023.05.034)
• [L5] [101] (10.1177/0363546517691278)
• [L3] In our series, the Haddad classification had the best interobserver reliability for arthroscopic assessment of chondral damage of the hip. [102] (10.1016/j.arthro.2015.02.029)
• [L4] For most patients, labral size does not appear to significantly alter patient outcomes or the need for arthroplasty. [104] (10.1016/j.arthro.2020.04.022)
• [L3] The locations predominantly involved with labral tears were different in FAI and mild dysplastic hips (anterior and anterosuperior zones) and in severely dysplastic hips (anterosuperior and superior zones). [107] (10.1302/0301-620x.95b10.31647)
• [L2] The noninvasive imaging modality of radially reconstructed MERGE MRI may be an alternative to magnetic resonance arthrography for evaluating labrum tears. [109] (10.1016/j.arthro.2019.05.006)
• [L2] Hip arthroscopic surgery is more cost-effective and results in a considerably lower incidence of symptomatic OA than structured rehabilitation alone in treating symptomatic labral tears of patients in the second to seventh decades of life without pre-existing OA. [112] (10.1177/0363546516645532)

See Also

• Femoroacetabular impingement
• Hip arthroscopy
• Periacetabular osteotomy

References

[1] Acetabular Labral Tears: Diagnosis, Repair, and a Method for Labral Reconstruction. Clinics in Sports Medicine. 2011. DOI: 10.1016/j.csm.2010.12.006

[2] Poster 143. Impact of Acetabular Labral Tear Location on Patient-Reported Outcomes and Conversion to Total Hip Arthroplasty Following Hip Arthroscopy with an 8-Year Minimum Follow-Up. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00443

[3] Impact of Acetabular Labral Tear Location on Patient-Reported Outcomes and Conversion to Total Hip Arthroplasty After Hip Arthroscopy With an 8-Year Minimum Follow-up. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261432671

[4] Acetabular labral tear is associated with high pelvic incidence with or without femoroacetabular impingement morphology. Knee Surgery, Sports Traumatology, Arthroscopy. 2022. DOI: 10.1007/s00167-022-06881-z

[5] Acetabular Labral Tears Are Common in Asymptomatic Contralateral Hips With Femoroacetabular Impingement. Clinical Orthopaedics & Related Research. 2018. DOI: 10.1097/corr.0000000000000567

[6] Repair versus Debridement for Acetabular Labral Tears—A Systematic Review. Arthroscopy, Sports Medicine, and Rehabilitation. 2021. DOI: 10.1016/j.asmr.2021.06.008

[7] Acetabular Cartilage Lesions Predict Inferior Mid‐Term Outcomes for Arthroscopic Labral Repair and Treatment of Femoroacetabular Impingement Syndrome. Arthroscopy. 2022. DOI: 10.1016/j.arthro.2022.05.013

[8] The Effect of Pelvic Incidence on Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement and Acetabular Labral Tears. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/2325967124s00007

[9] Primary Circumferential Acetabular Labral Reconstruction: Achieving Outcomes Similar to Primary Labral Repair Despite More Challenging Patient Characteristics. The American Journal of Sports Medicine. 2018. DOI: 10.1177/0363546518775425

[10] Hip Arthroscopy vs Physical Therapy for Acetabular Labral Tears: Analysis of a Prospective Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118s00071

[11] Do Larger Acetabular Chondral Defects Portend Inferior Outcomes in Patients Undergoing Arthroscopic Acetabular Microfracture? A Matched‐Controlled Study. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2019.01.047

[12] Acetabular Labral Tears Rarely Occur in the Absence of Bony Abnormalities. Clinical Orthopaedics and Related Research. 2004. DOI: 10.1097/01.blo.0000136903.01368.20

[13] The Labro-Acetabular Complex. Journal of Bone and Joint Surgery. 2011. DOI: 10.2106/jbjs.j.01710

[14] Comprehensive Morphologic Evaluation of the Hip in Patients with Symptomatic Labral Tear. Clinical Orthopaedics & Related Research. 2006. DOI: 10.1097/01.blo.0000246536.90371.12

[15] Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: A Randomized Controlled Trial. The American Journal of Sports Medicine. 2021. DOI: 10.1177/0363546521990789

[17] Surgical Decision Making for Acetabular Labral Tears: An International Perspective. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118797324

[18] Improvement in Functional Outcome Scores Despite Persistent Pain With 1 Year of Nonsurgical Management for Acetabular Labral Tears With or Without Femoroacetabular Impingement. The American Journal of Sports Medicine. 2018. DOI: 10.1177/0363546518814484

[19] Arthroscopic Treatment for Acetabular Labral Tears of the Hip without Bony Dysmorphism. The American Journal of Sports Medicine. 2011. DOI: 10.1177/0363546511412915

[20] Patients aged in their 70s do not have a high risk of progressive osteoarthritis following arthroscopic femoroacetabular impingement correction and labral preservation surgery. Knee Surgery, Sports Traumatology, Arthroscopy. 2019. DOI: 10.1007/s00167-019-05520-4

[21] Sex-Based Differences in the Clinical Presentation of Patients With Symptomatic Hip Labral Tears. The American Journal of Sports Medicine. 2014. DOI: 10.1177/0363546514532226

[22] Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: 24-Month Results From a Randomized Controlled Trial. The American Journal of Sports Medicine. 2024. DOI: 10.1177/03635465241263595

[23] Campbell S Operative Orthopaedics 4 Volume Set. ANTERIOR CRUCIATE AND ANTROLATERAL LIGAMENT RECONSTRUCTION (BOX 51.8) > ARTHROSCOPIC MANAGEMENT OF LABRAL TEARS.

[24] The Diagnostic Value of Ultrasound in Anterosuperior Acetabular Labral Tear. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2019.02.052

[25] CORR Insights®: Acetabular Labral Tears Are Common in Asymptomatic Contralateral Hips With Femoroacetabular Impingement. Clinical Orthopaedics & Related Research. 2019. DOI: 10.1097/corr.0000000000000606

[26] Why Do You Focus on the Acetabular Labral Tear? You Can’t See the Forest for the Trees. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.10.052

[27] Isolated focal cartilage and labral defects in patients with femoroacetabular impingement syndrome may represent new, unique injury patterns. Knee Surgery, Sports Traumatology, Arthroscopy. 2018. DOI: 10.1007/s00167-018-4861-2

[28] Minimum 5-Year Outcomes of Arthroscopic Hip Labral Reconstruction With Nested Matched-Pair Benchmarking Against a Labral Repair Control Group. The American Journal of Sports Medicine. 2019. DOI: 10.1177/0363546518825259

[29] Hip Arthroscopic Surgery. The American Journal of Sports Medicine. 2013. DOI: 10.1177/0363546513476281

[30] The Extension–Thickness–Damage (ETD) score: a pre-operative hip MR arthrography-based classification to predict type of labrum surgery. Archives of Orthopaedic and Trauma Surgery. 2019. DOI: 10.1007/s00402-019-03112-y

[31] Diagnostic Value of Ultrasound and Computed Tomographic Arthrography in Diagnosing Anterosuperior Acetabular Labral Tears. Arthroscopy. 2013. DOI: 10.1016/j.arthro.2013.07.274

[34] Editorial Commentary: Irreparable, Symptomatic, Hip Labral Tears Should Be Reconstructed in Patients without Osteoarthritis. However, Comparison of the Two, as Well as Allograft versus Autograft Reconstruction, Is Challenging. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2023.07.003

[35] Usefulness of Radial Contrast‐Enhanced Computed Tomography for the Diagnosis of Acetabular Labrum Injury. Arthroscopy. 2007. DOI: 10.1016/j.arthro.2007.07.005

[36] Mid- to Long-Term Outcomes of Hip Arthroscopy: A Systematic Review. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2021. DOI: 10.1016/j.arthro.2020.10.001

[38] High prevalence of acetabular retroversion in asymptomatic adults. The Bone & Joint Journal. 2017. DOI: 10.1302/0301-620x.99b12.37081

[40] Cam Deformities and Limited Hip Range of Motion Are Associated With Early Osteoarthritic Changes in Adolescent Athletes: A Prospective Matched Cohort Study. The American Journal of Sports Medicine. 2017. DOI: 10.1177/0363546517719460

[42] Irreparable Hip Labral Tears and Femoroacetabular Impingement Syndrome: Labral Reconstruction Incorporating the Transverse Acetabular Ligament May Restore the Suction Seal. Arthroscopy. 2020. DOI: 10.1016/j.arthro.2020.08.018

[43] Do Iatrogenic Punctures of the Labrum Affect the Clinical Results of Hip Arthroscopy?. Arthroscopy. 2011. DOI: 10.1016/j.arthro.2011.01.019

[44] Decreased Hip Labral Width Measured via Preoperative Magnetic Resonance Imaging Is Associated With Inferior Outcomes for Arthroscopic Labral Repair for Femoroacetabular Impingement. Arthroscopy. 2020. DOI: 10.1016/j.arthro.2020.08.006

[45] Bilateral Hip Arthroscopy: Direct Comparison of Primary Acetabular Labral Repair and Primary Acetabular Labral Reconstruction. Arthroscopy. 2017. DOI: 10.1016/j.arthro.2017.08.240

[46] Arthroscopic Reconstruction of the Irreparable Acetabular Labrum: A Match‐controlled Study. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2018.09.024

[47] Orthopaedic Knowledge Update Sports Medicine 6. Athletic Hip Injuries > Acetabular Labral Tears.

[48] Magnetic Resonance Imaging of Acetabular Labral Tears. Journal of Bone and Joint Surgery. 2011. DOI: 10.2106/jbjs.j.01722

[49] Magnetic Resonance Arthrography versus Arthroscopy in the Evaluation of Articular Hip Pathology. Clinical Orthopaedics and Related Research. 2004. DOI: 10.1097/01.blo.0000150125.34906.7d

[50] Clinical Presentation of Patients with Symptomatic Anterior Hip Impingement. Clinical Orthopaedics & Related Research. 2009. DOI: 10.1007/s11999-008-0680-y

[52] Rate of Return to Sport and Functional Outcomes After Bilateral Hip Arthroscopy in High-Level Athletes. The American Journal of Sports Medicine. 2019. DOI: 10.1177/0363546519885354

[55] Durable Outcomes After Hip Labral Reconstruction at Minimum 5‐Year Follow‐Up: A Systematic Review. Arthroscopy. 2023. DOI: 10.1016/j.arthro.2023.02.015

[56] The dimensions of the hip labrum can be reliably measured using magnetic resonance and computed tomography which can be used to develop a standardized definition of the hypoplastic labrum. Knee Surgery, Sports Traumatology, Arthroscopy. 2020. DOI: 10.1007/s00167-020-06330-9

[58] Hip Labral Tears among Asymptomatic Professional Hockey Players Identified on MRI. Orthopaedic Journal of Sports Medicine. 2013. DOI: 10.1177/2325967113s00057

[59] Arthroscopic Primary Labral Reconstruction in the Hip: Minimum 10-Year Outcomes With a Nested Propensity-Matched Control. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251392196

[60] Hip Arthroscopy in Patients Ages 50 Years or Older: Minimum 5‐Year Outcomes, Survivorship, and Risk Factors for Conversion to Total Hip Replacement. Arthroscopy. 2018. DOI: 10.1016/j.arthro.2018.05.034

[61] Influence of Acetabular Labral Tear Length on Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome With Capsular Plication. The American Journal of Sports Medicine. 2019. DOI: 10.1177/0363546519831291

[62] Predictors of Outcomes of Non-Surgical Management for Acetabular Labral Tears. Orthopaedic Journal of Sports Medicine. 2018. DOI: 10.1177/2325967118s00008

[63] Modest mid‐term outcomes after isolated arthroscopic debridement of acetabular labral tears. Knee Surgery, Sports Traumatology, Arthroscopy. 2014. DOI: 10.1007/s00167-014-2872-1

[67] 3.0 T MRI is more recommended to detect acetabular labral tears than MR Arthrography: an updated meta-analysis of diagnostic accuracy. Journal of Orthopaedic Surgery and Research. 2022. DOI: 10.1186/s13018-022-02981-1

[69] The Reliability of Arthroscopic Classification of Acetabular Rim Labrochondral Disease. The American Journal of Sports Medicine. 2012. DOI: 10.1177/0363546512457157

[71] The hip fluid seal—Part II: The effect of an acetabular labral tear, repair, resection, and reconstruction on hip stability to distraction. Knee Surgery, Sports Traumatology, Arthroscopy. 2014. DOI: 10.1007/s00167-014-2875-y

[74] Validity of Magnetic Resonance Imaging Measurement of Hip Labral Width Compared With Intraoperative Assessment. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2019.09.027

[83] Long-term Outcomes and Conversion to Total Hip Arthroplasty Based on Acetabular Labral Tear Size: Minimum 8-Year Follow-up. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671251410207

[89] Editorial Commentary: Hip Arthroscopy and Periacetabular Osteotomy in Patients 45 Years and Older Have Similar Outcomes to a Younger Cohort: Articular Cartilage Status Is the Primary Determinant of Outcome. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.11.074

[91] The Correlation Between Arthroscopically Defined Acetabular Cartilage Defects and a Proposed Preoperative Delayed Gadolinium‐Enhanced Magnetic Resonance Imaging of Cartilage Index in Hips of Patients With Femoroacetabular Impingement Syndrome. Arthroscopy. 2018. DOI: 10.1016/j.arthro.2017.10.023

[93] Arthroscopic Classification of Acetabular Rim Labrochondral Disease: Letter to the Editor. The American Journal of Sports Medicine. 2013. DOI: 10.1177/0363546513480110

[97] The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres. The Bone & Joint Journal. 2015. DOI: 10.1302/0301-620x.97b4.34638

[98] Radiographic and MR Imaging of the Athletic Hip. Clinics in Sports Medicine. 2006. DOI: 10.1016/j.csm.2005.12.009

[99] Histopathologic Features of the Acetabular Labrum in Femoroacetabular Impingement. Clinical Orthopaedics and Related Research. 2004. DOI: 10.1097/01.blo.0000144861.11193.17

[100] Microfracture of Acetabular Chondral Lesions Is Not Superior to Other Cartilage Repair Techniques in Patients With Femoroacetabular Impingement Syndrome: A Systematic Review. Arthroscopy. 2023. DOI: 10.1016/j.arthro.2023.05.034

[101] Cost-effectiveness Analysis of Hip Arthroscopic Surgery and Structured Rehabilitation Alone in Individuals With Hip Labral Tears: Letter to the Editor. The American Journal of Sports Medicine. 2017. DOI: 10.1177/0363546517691278

[102] Reliability of 3 Different Arthroscopic Classifications for Chondral Damage of the Acetabulum. Arthroscopy. 2015. DOI: 10.1016/j.arthro.2015.02.029

[104] Is Labral Size Predictive of Failure With Repair in Hip Arthroscopy?. Arthroscopy. 2020. DOI: 10.1016/j.arthro.2020.04.022

[107] Differences in the locations and modes of labral tearing between dysplastic hips and those with femoroacetabular impingement. The Bone & Joint Journal. 2013. DOI: 10.1302/0301-620x.95b10.31647

[109] Comparison Between 3‐Dimensional Multiple‐Echo Recombined Gradient Echo Magnetic Resonance Imaging and Arthroscopic Findings for the Evaluation of Acetabular Labrum Tear. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2019.05.006

[112] The Economic Impact of Acetabular Labral Tears. The American Journal of Sports Medicine. 2016. DOI: 10.1177/0363546516645532