Arthroscopic Acetabular Recession With Chondrolabral Preservation

Cam and pincer lesions found in femoral acetabular impingement (FAI) serve as bony substrates for the development of labral tears and can lead to osteoarthritis. Prior acetabuloplasty techniques have described surgical detachment of the labrum at the chondrolabral junction to facilitate osteoplasty. Histologically, the healing at the chondrolabral junction may be limited and surgical labral detachment may compromise the vascular supply to the labrum. We present a technique of maintaining the chondrolabral junction during acetabuloplasty. The labrum/chondral complex is subperiosteally elevated off the acetabular rim and the acetabular shelf is contoured with fluoroscopic guidance. Intermittent traction is used to minimize total traction time. Vertical mattress stitches are used to repair the labrum. The main advantage of this technique is that it allows contouring of the underlying pincer deformity commonly found in FAI without compromising the contiguous transition zone between the articular surface of the acetabulum and labrum.