Editorial Commentary: Proper Indications for Primary Labral Resection and Reconstruction Versus Primary Labral Repair Remain Vague and Undefined

Primary labral reconstruction for complex hip pathologies has shown outcomes and complication rates similar to those of labral repair. As surgeons become more proficient and versatile in their hip arthroscopy techniques, we are seeing increasing feedback supporting reconstructions in the primary setting. Patients with severe pincer impingement, hypotrophic labrums, labral ossification, or irreparable degenerative tearing demonstrate notable improvement and satisfaction after primary labral reconstruction. However, there still is benefit to retaining native labral tissue when feasible. Biomechanical studies show loss of suction seal and increased contact pressures with labral reconstructions versus repairs. Although primary labral reconstruction is a necessary skill and treatment option particularly for the complex hip, the pendulum may be starting to swing too far away from repairs or augmentations. Proper indications for primary labral reconstruction continue to evolve and are not yet black and white in the literature. Regardless, surgeons may rest assured that patients are demonstrating appropriate improvement and safety with either preferred surgical option.