Having previously published several short articles on femoroacetabular impingement (FAI), I would like to emphasize here that although acetabular glenoid labral injury and FAI are closely correlated, the two cannot be equated. I. Clinical manifestations of acetabular glenoid labral injury There are many causes of acetabular glenoid labral injury, such as traumatic, congenital (e.g., acetabular dysplasia or overcoverage), degenerative, and idiopathic. Most of the cases seen clinically are related to minor hip injuries or over-range of joint activities. Only one case in this group had a clear history of severe trauma, and most had a history of minor hip sprain. The main symptoms of acetabular labral injury were periprosthetic pain (mainly in the groin area) and joint locking. Joint popping, locking, or the patient’s self-reported “dead leg sign” are more diagnostic. After a glenoid labrum injury, the mobility of the hip joint can be limited to varying degrees in all directions, mainly in flexion and internal rotation, which is related to the fact that the anterior superior glenoid labrum is the most prone to injury. Of course, to determine the origin and etiology of hip pain, a comprehensive and detailed physical examination is needed to correctly distinguish between intra-articular and extra-articular disorders and to exclude other diseases that cause hip pain, such as diseases of the lumbar spine, sacroiliac joints or intrapelvic organs. Therefore, it is sometimes difficult to determine whether there is a glenoid labral injury based on imaging data alone, so I hope that patients who consult online will understand. Second, the imaging diagnosis of acetabular glenoid labral injury It is now widely believed that femoral acetabular impingement is inextricably linked to acetabular glenoid labral injury. Many patients with glenoid labral injuries have impingement, and the vast majority of patients with impingement also come to the clinic with symptoms due to glenoid labral injury. In the absence of calcification or ossification, the glenoid labrum itself does not appear on radiographs, so the main significance of radiography is to observe the morphology of the femoral head-neck junction area and the coverage and orientation of the acetabulum. The incidence of cam-type impingement was found to be 52%, clamp-type impingement 38%, and mixed-type 29% in this group of cases by X-ray examination, which has a fairly high incidence. Some patients had no obvious signs of impingement on X-ray, which suggests that we cannot exclude the possibility of glenoid labral injury in patients with pain in the groin area or hip strangulation, even if there are no positive changes on X-ray. As mentioned earlier, glenoid labral injury is not equivalent to femoroacetabular impingement. Two- and three-dimensional CT provides a clearer picture of the bony morphologic abnormalities of the acetabulum and proximal femur and also helps to determine the site of bone cutting and how much bone is present at the time of surgery. Conventional magnetic resonance imaging (MRI) does not have a high positive diagnostic rate for glenoid labral injuries. In addition to arthroscopy, magnetic resonance arthrography (MRA) is still the most sensitive and specific test and is the gold standard for acetabular glenoid labral injury diagnosis. The 3.0T MRI machines currently used in some hospitals are able to obtain clear images, improving the detection rate of glenoid labral injuries with general MRI, but the positive rate is still low compared to MRA. Arthroscopic treatment of acetabular labral injury Non-surgical treatment for patients with acetabular labral injury can relieve the symptoms, but cannot remove the cause. The advantage of incisional surgery (femoral head prolapse) is that the field of view is good and repair can be performed under direct vision, and most patients can obtain satisfactory clinical results. However, incisional surgery is very traumatic and has many complications, and its clinical application and related research are decreasing. Hip arthroscopy is less invasive and provides direct access to the central and peripheral compartments of the hip joint, allowing not only the management of glenoid labral injuries but also the dynamic evaluation and correction of bony abnormalities in the acetabular and femoral head neck regions. According to the literature, the overall outcome of arthroscopic surgery for glenoid labral injuries is superior to that of incisional surgery. The acetabular glenoid labrum is a fibrocartilaginous structure that attaches to the edge of the bone and has a poor healing capacity. Glenoid labral tears tend to show thickening, edema, or degenerative roughness, and may occur with free broken ends, most of which are not eligible for suture repair. Therefore, excisional cleanup of the injured glenoid labrum is generally used, which is easy to perform, has short operative time and lower extremity traction time, and can achieve good clinical results. The scope of glenoid labrum resection is limited and does not constitute substantial damage to the stability of the joint. However, the acetabular glenoid labrum theoretically has the role of limiting the synovial fluid outflow in the joint, and the absence of the glenoid labrum will reduce the function of its sealing ring. Therefore, healthy glenoid labral tissue with better healing prospects should be repaired. Such reports are also increasing year by year. Bone reduction (plication) of the femoral head and neck junction area can reconstruct the eccentric spacing and rounded femoral head morphology of the head and neck junction area, eliminating the factor of cam-type impingement. For some clamping-type impingements, relief can be obtained by arthroscopic resection of the hyperplastic acetabular rim. It should be noted, however, that not all deformities of the cephalocervical region require bone reduction shaping. a follow-up study by Bardakos et al. over 10 years found that a lance handle-like deformity of the femoral cervical junction region (cam-type impingement) did not necessarily lead to progression of arthritis. In our group, 11 patients had an alpha angle >50, but microscopic observation revealed the presence of impingement in only 7 cases, the others did not undergo osteoplasty of the head and neck region. According to the literature, the incidence of complications was similar for both initial and repeat hip arthroscopy, about 1.4%-5%, which were lower than for incisional surgery, mostly related to patient position and traction, and the risk of injury to the lateral femoral cutaneous nerve with the anterior approach. One case of lateral femoral cutaneous nerve injury occurred in our group.