The acetabular labrum is a triangular fibrocartilaginous ring deepening the acetabular socket and sealing the intra-articular fluid film. Its superior-anterior sector (10-2 o'clock) bears the highest load during standing and walking — this is the most common location of labral tears. Labral tears from femoroacetabular impingement (FAI), hip dysplasia, or trauma produce the sharp anterior hip pain of the impingement sign (hip flexion-adduction-internal rotation).
Labral tears at the anterior-superior rim are confirmed by MRI arthrography (gadolinium injected into the hip joint). Arthroscopic labral repair (suture anchor reattachment) achieves 85-90% good-excellent outcomes when combined with FAI osteoplasty. Labral reconstruction using iliotibial band or ligamentum teres graft is required when the labrum is too degenerate for repair.
FAI-related labral tear at the 12-2 o'clock acetabular position producing hip impingement pain managed with arthroscopic repair and cam/pincer osteoplasty.
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