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arthroscopy and arthroplasty

Joseph F Konopka, Robert L Buly, Bryan T Kelly, Edwin P Su, Alexander S McLawhorn
BACKGROUND: A significant number of patients who undergo hip arthroscopy will subsequently undergo total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA), although limited evidence exists regarding effects of prior hip arthroscopy on the outcomes of these procedures. METHODS: Of 5091 patients who underwent hip arthroscopy, we identified 69 patients who underwent subsequent THA (46) or HRA (23). Patients were matched to patients with no history of hip arthroscopy...
February 2, 2018: Journal of Arthroplasty
Louis F McIntyre
A considerable body of literature with high-level evidence has been published in the past 15 years calling into question the value of arthroscopic surgery in treating osteoarthritis of the knee (OAK). This, plus recent guidelines advising against the use of conservative treatments such as hyaluronic viscosupplementation, threatens to limit patient access to treatment for a chronic disease state with no known cure. The disease burden of OAK is considerable and represents one of the largest health care dollar expenditures in the United States and the world...
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
William R Aibinder, Joaquin Sanchez-Sotelo
The incidence of venous thromboembolic events (VTEs) complicating shoulder surgery is difficult to estimate. Case reports, retrospective studies, prospective studies, and systematic reviews vary in terms of separating symptomatic versus asymptomatic VTEs, those occurring in the upper versus lower extremities, and those leading to pulmonary embolism. Reported rates vary between 0.02% and 13%. Arthroplasty is associated with a higher incidence than arthroscopy. Surgery for fracture presents increased risk. Mechanical prophylaxis using compression devices could be considered given its favorable risk-benefit profile...
April 2018: Orthopedic Clinics of North America
Jonathan D Bartlett, John E Lawrence, Vikas Khanduja
PURPOSE: To determine: (1) What is the proximity of the lateral femoral cutaneous nerve (LFCN) to the anterior portal (AP) used in supine hip arthroscopy? (2) What is the proximity of the LCFN to the incision in the minimally invasive anterior approach (MIAA) for total hip arthroplasty? (3) What effect does lateralizing the AP have on the likelihood of nerve injury? (4) What branching patterns are observable in the LFCN? METHODS: Forty-five hemipelves were dissected...
February 23, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kyle R Sochacki, Robert A Jack, Marc R Safran, Shane J Nho, Joshua D Harris
PURPOSE: The purpose of this study was to compare (1) major complication, (2) revision, and (3) conversion to arthroplasty rates following hip arthroscopy between database studies and original research peer-reviewed publications. METHODS: A systematic review was performed using PRISMA guidelines. PubMed, SCOPUS, SportDiscus, and Cochrane Central Register of Controlled Trials were searched for studies that investigated major complication (dislocation, femoral neck fracture, avascular necrosis, fluid extravasation, septic arthritis, death), revision, and hip arthroplasty conversion rates following hip arthroscopy...
February 21, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
M T Sanchez-Santos, C Garriga, A Judge, R N Batra, A J Price, A D Liddle, M K Javaid, C Cooper, D W Murray, N K Arden
To develop and validate a clinical prediction model of patient-reported pain and function after undergoing total knee replacement (TKR). We used data of 1,649 patients from the Knee Arthroplasty Trial who received primary TKR across 34 centres in the UK. The external validation included 595 patients from Southampton University Hospital, and Nuffield Orthopaedic Centre (Oxford). The outcome was the Oxford Knee Score (OKS) 12-month after TKR. Pre-operative predictors including patient characteristics and clinical factors were considered...
February 21, 2018: Scientific Reports
Renato Locks, Ioanna K Bolia, Hajime Utsunomiya, Karen K Briggs, Marc J Philippon
PURPOSE: To determine the causes of revision hip arthroscopy in patients who underwent labral reconstruction and to compare outcomes of these patients with patients who did not require a revision following reconstruction. METHODS: Patients who underwent revision hip arthroscopy after previous labral reconstruction from 2006 to 2014 were included. Patients with less than 2-year follow-up, preoperative joint space of ≤2 mm, or who underwent other reconstructive procedures at the time of labral reconstruction were excluded...
February 15, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jonathan A Flug, Alissa Burge, Darius Melisaratos, Theodore T Miller, John A Carrino
Sciatica is a highly prevalent cause of morbidity, commonly resulting from intra-spinal pathological processes. Many cases can have extra-spinal etiologies and can be clinically challenging. Certain scenarios should suggest an extra-spinal etiology, particularly total and revision hip arthroplasty, surgical hip dislocation, hip arthroscopy, and surgery in the lithotomy position. We review the post-operative clinical scenarios where sciatic neuropathy may occur, along with the pertinent imaging findings.
February 8, 2018: Skeletal Radiology
Renato Locks, Jorge Chahla, Ioanna K Bolia, Karen K Briggs, Marc J Philippon
The purpose of this study was to determine the outcomes following segmental labral reconstruction (labral defects measuring <1 cm) using a segment of capsular tissue or a segment of the indirect head of rectus femoris tendon. Eleven patients (five females and six males) underwent segmental labral reconstruction using a segment of capsule (eight patients) or indirect head of rectus tendon (three patients) by a single surgeon from March 2005 to October 2012. The average age of the patients was 35 years old (range, 20-51 years)...
January 2018: Journal of Hip Preservation Surgery
Matthew T Philippi, Timothy L Kahn, Temitope F Adeyemi, Travis G Maak, Stephen K Aoki
Many hip arthroscopy patients experience significant pain in the immediate postoperative period. Although peripheral nerve blocks have demonstrated efficacy in alleviating some of this pain, they come with significant costs. Local infiltration analgesia (LIA) may be a significantly cheaper and efficacious treatment modality. Although LIA has been well studied in hip and knee arthroplasty, its efficacy in hip arthroscopy is unclear. The purpose of this retrospective study is to determine the efficacy of a single extracapsular injection of bupivacaine-epinephrine during hip arthroscopy in reducing the rate of elective postoperative femoral nerve blocks...
January 2018: Journal of Hip Preservation Surgery
Jason J Shin, Darren L de Sa, Jeremy M Burnham, Craig S Mauro
With increased knowledge and understanding of hip pathology, hip arthroscopy is rapidly becoming a popular treatment option for young patients with hip pain. Despite improved clinical and radiographic outcomes with arthroscopic treatment, some patients may have ongoing pain and less than satisfactory outcomes. While the reasons leading to failed hip arthroscopy are multifactorial, patient selection, surgical technique and rehabilitation all play a role. Patients with failed hip arthroscopy should undergo a thorough history and physical examination, as well as indicated imaging...
January 2018: Journal of Hip Preservation Surgery
Itay Perets, David E Hartigan, John P Walsh, Austin W Chen, Brian H Mu, Benjamin G Domb
PURPOSE: To evaluate clinical outcomes, demographics, and radiographic findings for patients whose hip arthroscopies involved amorphous calcification (AC) excision and to compare them with a control group with no AC and with the general population regarding diabetes mellitus and hypothyroidism. METHODS: Patients who underwent primary hip arthroscopy involving surgical excision of AC deposit in the anterosuperior labralcapsular recess between October 2008 and July 2014 were reviewed...
January 27, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Andrew J Bryan, Kirsten Poehling-Monaghan, Aaron J Krych, Bruce A Levy, Robert T Trousdale, Rafael J Sierra
The purpose of this study was to compare a group of dysplastic hips treated successfully with hip arthroscopy with a group of dysplastic hips treated unsuccessfully with hip arthroscopy to determine (1) preoperative patient characteristics and radiographic parameters and (2) intraoperative findings and treatment associated with outcome. The authors retrospectively reviewed a prospective database of 20 adult patients (17 female, 3 male) with hip dysplasia who underwent primary hip arthroscopy between January 2009 and February 2013...
January 25, 2018: Orthopedics
Anas A Minkara, Robert W Westermann, James Rosneck, T Sean Lynch
BACKGROUND: Femoroacetabular impingement (FAI) has become a more commonly recognized cause of limited hip range of motion and hip pain among young adults and athletes. Hip arthroscopy is recommended for the surgical treatment of this disorder, unless specific contraindications exist. Despite the increasing rate of published studies in this area, there remains no aggregate data for outcomes after this approach. PURPOSE: To evaluate risk factors and outcomes after arthroscopic management of FAI, including return to play, revision rate, surgical and nonsurgical complications, change in α-angle, intraoperative bone resection, and patient-reported outcomes...
January 1, 2018: American Journal of Sports Medicine
Benjamin G Domb, Edwin O Chaharbakhshi, Itay Perets, John P Walsh, Leslie C Yuen, Lyall J Ashberg
PURPOSE: To elucidate whether capsular closure during hip arthroscopy affected patient outcomes over midterm follow-up. METHODS: Between 2008 and 2011, data were prospectively collected and retrospectively reviewed on patients who underwent hip arthroscopy. Patients were then matched for age, gender, worker's compensation, body mass index, and acetabular coverage. The inclusion criteria were capsular repair or unrepaired capsulotomy, lateral-center edge angle ≥18°, and minimum 5-year follow-up...
January 16, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Nabil Mehta, Peter Chamberlin, Robert G Marx, Chisa Hidaka, Yile Ge, Danyal H Nawabi, Stephen Lyman
BACKGROUND: Hip arthroscopy has emerged as a successful option for the treatment of femoroacetabular impingement and related hip disorders, but the procedure is technically challenging. PURPOSE: To define the learning curve through which surgeons become proficient at hip arthroscopy. STUDY DESIGN: Cohort study; level of evidence, 3. METHODS: The authors identified hip arthroscopy procedures performed by surgeons through a New York State database (Statewide Planning and Research Cooperative System) and followed those cases for additional hip surgery (total hip arthroplasty, hip resurfacing, or ipsilateral hip arthroscopy) within 5 years of the original procedure...
January 1, 2018: American Journal of Sports Medicine
Benjamin S Kester, Brian Capogna, Siddharth A Mahure, Michael K Ryan, Brent Mollon, Thomas Youm
PURPOSE: To use a large heterogeneous population to identify independent risk factors for revision surgery or conversion to total hip arthroplasty (THA) after hip arthroscopy. METHODS: The New York Statewide Planning and Research Cooperative System database was queried from 2011 through 2012 to identify patients undergoing hip arthroscopy. All patients aged 18 years or older who underwent hip arthroscopy according to Current Procedural Terminology coding were included...
January 3, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Eric J Cotter, Rachel M Frank, Kevin C Wang, Trifon Totlis, Sarah Poland, Maximillian A Meyer, Brian J Cole
PURPOSE: To report clinical outcomes of osteochondral allograft transplantation (OCA) for skeletally mature patients with osteochondritis dissecans (OCD) lesions of the knee in whom prior surgical intervention has failed, and to describe return-to-sport (RTS) rates and any predictive demographic or preoperative variables associated with a higher likelihood to RTS. METHODS: Patients who underwent OCA by a single surgeon (B.J.C.) between October 1, 2002, and November 30, 2014, for a diagnosis of OCD with a minimum of 2 years' follow-up were included...
January 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Jessica L Churchill, Nipun Sodhi, Anton Khlopas, Nicolas S Piuzzi, Sarah E Dalton, Morad Chughtai, Assem A Sultan, Steven Jones, Nick Williams, Peter M Bonutti, Michael A Mont
Background: Although arthroscopy is generally considered to be a relatively benign procedure with limited trauma to periarticular soft tissues, post-arthroscopic bleeding as well as osmolality differences between the normal saline used to irrigate and the native synovial fluid (282 vs. 420 mOs) can lead to capsular reactions. Therefore, the purpose of this study was to evaluate whether capsular reaction occurred after knee arthroscopy, by comparing a matched cohort of patients who either did or did not undergo prior arthroscopic surgery...
December 2017: Annals of Translational Medicine
Martin Hufeland, Markus Gesslein, Carsten Perka, Jörg Hartmut Schröder
INTRODUCTION: Pigmented villonodular synovitis (PVNS) is a rare, destructive synovial disease that affects the hip joint the second most common after the knee. However, in contrast, joint preserving surgery in the hip joint is considered to be significantly more difficult or even impossible due to earlier occurrence of osteochondral dissemination and surgical difficulties. Today, earlier diagnosis due to the generous use of MRI and modern surgical strategies raise hope for improved outcomes...
December 27, 2017: Archives of Orthopaedic and Trauma Surgery
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