degeneration that may have predisposed to the acute tear. Also, there will often be some accompanying articular damage. The extent of this may be a significant influencing factor on the eventual response to debridement.
Labral tears can be adequately accessed through the three standard portals. Similar to a meniscus in the knee, the task is to remove unstable and diseased labrum, creating a stable transition to retained healthy
tissue. The most difficult aspect is usually creating the stable transition zone. Thermal devices have been quite useful at ablating unstable tissue adjacent to the healthy portion of the labrum. Caution is necessary because of the concerns regarding depth of heat penetration, but with judicious use, these devices have been exceptionally useful for precise labral debride-ment despite the constraints created by the architecture of the joint.
The natural evolution in arthroscopic management of labral pathology is from debridement to repair. Cur-
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