Hip Labral Reconstruction: Lessons Learned from 1000 Cases.

Hip labral reconstruction has evolved into a reproducible and effective technique for managing irreparable labral tears. The knotless pull-through method eliminates graft sizing, simplifies passage, and ensures secure fixation. Based on experience with over 1000 cases, key lessons include meticulous rim preparation, consistent suture management, and the importance of graft availability even when repair is planned. Patient-reported outcomes and return-to-sport rates are consistently improved and comparable to labral repair, while reconstruction remains clearly superior to excision or debridement. Careful patient selection and technical precision are essential for optimizing long-term survivorship.