Orthopedics & Orthopedic Surgery
Area of Focus: Arthroscopy and Sports Medicine
Hip pain is often associated with intra-articular pathology, such as synovitis, labral tears, and chondromalacia. Acetabular labral tears are associated with the development of hip osteoarthritis. Early clinical results of hip arthroscopy and open surgical treatment of labral cartilage tears supports the preservation and repair of labral cartilage rather than indiscriminate debridement. Surgical techniques have been developed to repair acetabular labral tears. Often two questions arise: (1) whether a more anatomic repair is beneficial for patient healing and recovery and (2) what technique should be used for labral cartilage repair. The issue presented by the first question is that anatomic repair is technically demanding and poses a theoretical risk of early failure based on its reliance on intra-substance suture passage. To answer the second question, two primary modes of labral suture repair are in general use. One involves a loop construct; the other an intra-substance technique. One such intra-substance technique is the Iberian suture technique, which is an arthroscopic anatomic labral repair for the hip. The technique uses a two-portal hip arthroscopy method, which is detailed in this video. In addition, the video presents a complete surgical case with technical pearls and pitfalls, post-operative rehabilitation recommendations, and early clinical outcomes.