Arthroscopic management of labral tears in femoroacetabolar impingement: current concepts

INTRODUCTION: Surgical intervention for labral lesions associated with femoroacetabular impingement (FAI) has evolved significantly over the past two decades. The earliest surgical approaches include labral debridement and labral repair. More recently, the concept of labral reconstruction has gained popularity. Despite these advancements, a consensus regarding the optimal surgical approach remains elusive. The present systematic review updates the current evidence on the arthroscopic management of labral ailments in patients with symptomatic FAI.

METHODS: This systematic review adhered to the PRISMA statement. The Web of Science, PubMed, and Embase databases were accessed in July 2025. All clinical investigations comparing two different labral management methods for FAI were included.

RESULTS: Data from 23,222 patients were retrieved. Of them, 54.6 % (12,683 of 23,222 patients) were women. The mean follow-up duration was 33.0 ± 19.4 months. The mean age was 35.0 ± 6.3 years, and the mean BMI was 25.1 ± 1.3 kg/m2.

CONCLUSIONS: The current evidence on arthroscopic management of labral tears in femoroacetabular impingement is limited and heterogeneous. Available data suggest potential advantages of labral preservation and reconstruction over debridement, but these findings cannot be considered definitive. At present, no strong clinical recommendations can be made. Further randomized controlled trials with long-term follow-up are required to clarify the optimal surgical strategy.