In certain circumstances the specialized cartilage of the labrum is not able to be repaired because it is too small, degenerated, calcified or of poor quality.  This can result from an extensively damaged labrum, from a failed prior surgery, from surgical excision or trimming, from scar tissue or as a result of genetics.  Without a labrum the hip can become unstable, painful and can potentially develop arthritis earlier; therefore, it is important to attempt to re-create a labrum.  A labral reconstruction is an arthroscopic surgery that replaces a small, poor-quality, excessively damaged or non-existent labrum with a new labrum.  Cadaver tissue is used to re-create a new labrum.  This tissue is then inserted into the joint and secured on the rim of the socket from the front to the back using multiple suture anchors, similar to a labrum repair.  Once completed the new labral graft re-creates the hip seal by contacting the ball (femoral head) circumferentially.  This surgery is more technically demanding and therefore requires more time to complete than a standard hip arthroscopy.  Additionally, rehabilitation after a labral reconstruction is slower to protect the graft and allow for proper healing of the new labrum to the bony rim.  Protected weight-bearing and a brace will be required for 6-8 weeks, and therapy will be recommended for at least 3-4 months.