Preoperative radiographic measurements may help predict which patients with hip labral tears ultimately undergo repair versus primary reconstruction. This study investigated if radiographic parameters: (i) preoperatively predict labral repair versus reconstruction and (ii) correlate with T2 magnetic resonance imaging (MRI) mapping values of the labrum. This retrospective comparative study included patients aged 14–50 years who underwent labral repair or reconstruction at a single institution over a 2-year period. Patients with prior open or arthroscopic hip surgery or who had inadequate preoperative computed tomography (CT) and MRI imaging were excluded. Labral size was measured at multiple positions on preoperative MRI images. A blinded reviewer used three-dimensional CT analysis to record lateral center edge angle (LCEA), acetabular version, Tonnis angle, acetabular coverage, alpha angle, femoral torsion, and neck-shaft angle (FNSA). T2 MRI mapping values of the labrum were obtained via sequencing analyses on each patient’s optimal sagittal cut. Univariate mixed linear models were used to identify associations between each radiographic measurement and decision to repair or reconstruct the labrum. Fifty-two operations were included. Labral size had no predictive effect on undergoing labral reconstruction versus repair. Likelihood for undergoing labral reconstruction was associated with LCEA (P = .003) and Tonnis angle (P = .034). There was an association (P < .05) between labral T2 mapping values and all radiographic parameters except for FNSA and combined version. Labral size was not associated with whether patients underwent labral reconstruction or repair. The data showed an association between labrum T2 mapping values and nearly all radiographic parameters.
