Comparing Outcomes of Labrum Preservation vs Excision in Primary Total Hip Arthroplasty

Labral Excision vs Preservation in Primary Total Hip Arthroplasty: A Prospective Randomized Controlled Trial

This research is being done to determine whether removing or preserving the acetabular labrum, a ring of cartilage around the hip socket, during hip replacement surgery affects post-operative outcomes, operative time, or ease of placing the hip implant.

Both techniques (labrum removal and labrum preservation) are commonly performed by surgeons during total hip arthroplasty (THA). However, there is no definitive evidence showing whether one approach is better than the other. The goal of this study is to compare recovery and surgical factors between these two routinely used methods.

Inclusion Criteria:

• Age ≥ 18 years.
• Indication for primary unilateral total hip arthroplasty for osteoarthritis (Tonnis grade ≥2 or surgeon's standard indication).
• Able to provide informed consent and complete PROMs in English (or validated local language instruments).

Exclusion Criteria:

• Prior ipsilateral hip replacement or resurfacing.
• Active infection or inflammatory arthritis where labral management is judged by the surgeon to be non-standard.
• Severe acetabular bone loss or deformity requiring custom implants or complex reconstruction (Crowe III/IV dysplasia).
• Planned simultaneous bilateral hip arthroplasty.
• Preoperative heterotopic ossification.
• Cognitive impairment preventing consent or completion of PROMs.
• Patients for whom the surgeon believes leaving the labrum would be unsafe (e.g., gross interposed soft tissue preventing any reasonable cup placement without removal)