Editorial Commentary: No Longer a Salvage Procedure: Allograft Labral Reconstruction of the Hip Rivals the Results of Labral Repair.

Abstract In the past 5 years, arthroscopic labral reconstruction of the hip has rapidly evolved from a salvage procedure used primarily in the setting of multiple failed prior hip surgical procedures to an alternative, and even preferable, primary treatment option for labral pathology and femoroacetabular impingement. As opposed to labral repair, labral reconstruction allows for complete removal of all damaged, pain-generating tissue; optimal correction of underlying bony impingement; and consistent creation of a graft that appropriately restores the fluid hip seal, improves pressurization and stabilization, and decreases contact pressure. Allograft tissue, in particular, allows for accurate and reliable graft length creation and does not rely on native tissue quality. Hips that undergo labral reconstruction have been shown to have positive outcomes at minimum 2-year follow-up, despite the fact that in many cases, these hips have more damage and a poorer preoperative prognosis. Patients report decreased pain, increased function, and greater quality of life after labral reconstruction, and this new evidence suggests that they can resume high-level physical activity as well. Circumferential labral reconstruction is no longer a salvage procedure and is an important tool for the hip arthroscopist; however, it requires high proficiency in hip arthroscopy to perform.