An in vitro investigation of the acetabular labral seal in hip joint mechanics

Hip Arthroscopy Improves Symptoms Associated with FAI in Selected Adolescent Athletes

“…Some efforts have been focused on preserving and repairing labral tissue whenever possible. Biomechanical studies have indicated that intact labral tissue supports natural joint lubrication and the presence of a 'suction seal' that limits translation and instability [21][22][23]34]. Espinosa et al reported patients treated with labral refixation rather than débridement had superior clinical and radiographic improvements as measured by the Tönnis arthrosis classification system and Merle d'Aubigné-Postel clinical score at 1 and All means improved positively between preoperative and postoperative period.…”

The Concept of Femoroacetabular Impingement: Current Status and Future Perspectives

“…To expose the acetabular rim for trimming bony overgrowth as well as providing an intact acetabular cartilage interface, the labrum should be taken down as a part of the approach and should be reattached. Considering its physiological role [14][15][16], the reattachment of the intact portion of the labrum [26] appears logical since an absent labrum might, similar to meniscectomy of the knee, lead to OA. Successful refixation requires a labral substance of sufficient quality and bony procedures to correct the FAI performed with high precision [13], and presumably allowing the labrum to regain its physiological function (sealing, pressure distribution).…”

The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment

“…However, at this layer it is not uncommon to experience labral insult, ligamentum teres tear, capsular instability, ligament tears and adhesive capsulitis. The loss of labral suction seal has been shown to have increased femoral head displacement in cadaveric hips [17][18][19]. Translation of hip joint center may be as much as 2-5 mm for that loose hip further stressing inert and contractile tissue [20,21].…”

“…The most superficial layer comprises 10-20% of the total cartilage thickness, the middle layer comprises 40-60% of the articular volume whereas the deepest layer is 30% of the overall thickness [16]. The work of Ferguson et al [17] demonstrated the relationship and interaction which exist between Layers I and II. Forces to distract the head of the femur by 3 mm after venting the capsule and creating a labral tear decreased by 43% and 60% respectively.…”