FP3.4 Labral debridement and labral repair in isolated labral pathology of the hip: do both work?

Abstract ICLB03 - The Labral Reconstruction Masterclass: Autografts, Allografts, and Technical Frontiers, Session Room 12 (BMCC Level 3), October 8, 2026, 10:30 - 12:30 Introduction Arthroscopic management of femoroacetabular impingement (FAI) with bony resection and labral preservation has demonstrated favorable outcomes. However, isolated arthroscopic labral debridement has historically been associated with higher failure rates and conversion to total hip arthroplasty (THA). Symptomatic isolated labral pathology, often traumatic in etiology, represents a distinct clinical entity, and the optimal surgical management in this population remains unclear. This study aims to compare outcomes following labral repair versus debridement in patients with isolated labral pathology. Methods A retrospective review was performed on 164 patients undergoing hip arthroscopy between 2018–2021. Exclusion criteria included cam resection and revision arthroscopy. Acetabular rim trimming was permitted. A total of 132 patients met inclusion criteria: 81 underwent labral repair and 51 underwent labral debridement. Radiographic analysis confirmed absence of dysplasia and cam morphology, with mean lateral center-edge angle (LCEA) of 28.0°, Tönnis angle of 6.4°, and alpha angle of 39.1°. Patient-reported outcome measures (PROMs) included iHOT-12, PROMIS Global Mental Health, PROMIS Global Physical Health, Global Health Score, and Numeric Pain Rating Scale (NPRS), collected preoperatively and postoperatively at multiple time points up to 2 years. Results Groups were well matched for demographics and follow-up. Mean age was 32 years in the repair group and 35 years in the debridement group, with mean follow-up of 21.1 and 22.4 months, respectively. Both groups demonstrated improvement across all PROMs. Mean iHOT-12 improved from 32.9 to 57.9 at 3 months, 60.3 at 1 year, and 53.7 at 2 years in the repair group, and from 28.8 to 52.3, 51.2, and 52.1, respectively, in the debridement group. Debridement showed slightly greater early improvement, while repair demonstrated higher scores at 1 year and beyond. PROMIS Physical Health improved in both groups at 3 months and was maintained at 1 year, while PROMIS Mental Health remained stable. Global Health Scores improved modestly, and pain scores decreased from approximately 6 preoperatively to 3.5 at 3 months and 1 year in both groups, with slight increase at 2 years. Survey compliance declined over time, with overall response rates of 55.6% at 3 months, 49.6% at 1 year, and 36.1% at 2 years (33.3% debridement vs 37.8% repair). Conclusion Both labral repair and debridement result in meaningful clinical improvement in isolated labral pathology. Debridement may provide faster early symptom relief, while repair demonstrates more sustained functional outcomes at mid-term follow-up. Declining compliance at longer-term follow-up, particularly at 2 years, may influence the interpretation of iHOT-12 outcomes and should be considered when comparing durability between groups.