Segmental and Circumferential Hip Labral Reconstructions Both Show Favourable Outcomes in Primary Hip Arthroscopy: A Systematic Review
Arthroscopy The Journal of Arthroscopic and Related Surgery · 6 Sept 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Hip arthroscopists frequently must choose between segmental and circumferential labral reconstruction when a labrum is unsalvageable, and this review highlights that the choice currently rests on limited, non-comparative, low-level evidence rather than proven superiority of either technique.
The evidence
This systematic review pooled 9 studies (13 cohorts, 371 hips) of primary hip labral reconstruction, comparing segmental (partial labral replacement) versus circumferential (full labral replacement) techniques for irreparable labral tears. Both techniques showed favourable patient-reported outcomes at midterm follow-up (postoperative modified Harris Hip Score 75.6-89.0 for segmental vs 83.6-87.8 for circumferential; iHOT-12 63.9-76.7 vs 73.6-79.5), with revision/THA conversion rates ranging 0-20% for segmental and 0-5.4% for circumferential cohorts, but only one study directly compared the two approaches head-to-head.
A coherent primary effect estimate is unavailable. Clinical relevance does not estimate treatment benefit.
Why this rigour score?
Meta-analysis of observational studiesDesign starting point: 37.4
Raised the score
- Comprehensive literature search+3.4
- Risk of bias assessed in the included studies+3.4
Lowered the score
- Pools observational studies−6.8
Methods at a glance
Recorded assessment- Comprehensive literature searchMet
- Risk of bias assessedMet
- Bias considered in synthesisNot met
- Publication bias assessedNot met
- Study exclusions justifiedNot met
- Prospective registrationNot reported
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
See the full score breakdown
- Study design starting point
- 37.4
- Pools observational studies
- −6.8
- Comprehensive literature search
- +3.4
- Risk of bias assessed in the included studies
- +3.4
- Journal prior (not an observed method)
- +1
- Final rigour score rounded
- 38 / 100
Study design sets the starting point and a ceiling of 78. Recorded methods then adjust the score. Points are shown to one decimal place; the final score uses unrounded values.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.When a labrum is deemed irreparable intraoperatively, how should surgeons decide between preserving remaining healthy tissue with segmental reconstruction versus performing a full circumferential reconstruction?
2.Given the higher failure rate seen with allograft segmental reconstruction in one cohort, should graft type (autograft vs allograft) influence the choice of segmental versus circumferential technique in individual patients?
Original publication title
Segmental and Circumferential Hip Labral Reconstructions Both Show Favorable Outcomes in Primary Hip Arthroscopy: A Systematic Review