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Total hip arthroscopy

Daniel W Griffin, Matthew J Kinnard, Peter M Formby, Michael P McCabe, Terrence D Anderson
BACKGROUND: The indications for hip preservation surgery have expanded to include treatment of hip pathology in older adults. While several studies have examined the efficacy of hip arthroscopy in the setting of osteoarthritis, there has been no review of outcomes in older adults. PURPOSE: To review the outcomes of hip arthroscopy in older adults and identify factors associated with treatment failures. STUDY DESIGN: Systematic review. METHODS: PubMed, EMBASE, and the Cochrane Library were searched through March 2016 for studies reporting outcomes of primary hip arthroscopy in patients older than 40 years...
October 18, 2016: American Journal of Sports Medicine
Amir Shlaifer, Zachary Tuvya Sharfman, Hal David Martin, Eyal Amar, Efi Kazum, Yaniv Warschawski, Matan Paret, Silviu Brill, Michael Drexler, Ehud Rath
PURPOSE: To evaluate and compare the efficacy of intra-articular and periacetabular blocks for postoperative pain control after hip arthroscopy. METHODS: Forty-two consecutive patients scheduled for hip arthroscopy were randomized into 2 postoperative pain control groups. One group received preemptive intra-articular 20 mL of bupivacaine 0.5% injection, and the second group received preemptive periacetabular 20 mL of bupivacaine 0.5% injection. Before closure all patients received an additional dose of 20 mL of bupivacaine 0...
October 8, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Pascal Cyrill Haefeli, Christoph Emanuel Albers, Simon Damian Steppacher, Moritz Tannast, Lorenz Büchler
BACKGROUND: In recent years, surgical treatment of symptomatic femoroacetabular impingement (FAI) has been increasingly performed using arthroscopy. Bony pathomorphologies and damage to the labrum as well as cartilage defects can be addressed with comparable results to open surgery with overall less surgery-related complications. Despite the increasing importance of hip arthroscopy, however, reports on midterm clinical and radiographic outcomes and comparison to open surgical hip dislocation are scarce...
October 7, 2016: Clinical Orthopaedics and related Research
Kotaro R Shibata, Shuichi Matsuda, Marc R Safran
PURPOSE: The purpose of this study was to determine whether or not there is a distinct pattern of injury to the acetabular labrum and/or cartilage in the hip with instability without bony dysplasia. METHODS: Surgical records and intra-operative images of consecutive patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and/or hip instability by the senior author from April 2007 to December 2014 were retrospectively reviewed. Pathological changes were documented and charted on a novel diagram of the acetabulum, and classified into eight patterns corresponding to the lesion's location and size...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Nolan S Horner, Seper Ekhtiari, Nicole Simunovic, Marc R Safran, Marc J Philippon, Olufemi R Ayeni
PURPOSE: To (1) report clinical outcomes, complication rates, and total hip arthroplasty (THA) conversion rates for patients age 40 or older who underwent hip arthroscopy, and (2) report any age-related predictors of outcome identified in the literature. METHODS: MEDLINE, EMBASE, and PubMed were searched for relevant studies and pertinent data were abstracted from eligible studies. No meta-analysis was performed because of heterogeneity amongst studies. RESULTS: Seventeen studies were included in this review comprising 16,327 patients, including 9,954 patients age 40 or older...
September 10, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Darren de Sa, Kellee Stephens, Michelle Kuang, Nicole Simunovic, Jon Karlsson, Olufemi R Ayeni
Health care facilities produce significant waste (2200 kg/bed/year) creating 2% of greenhouse gas emissions and 1% total solid waste nationwide, with 20-70% of waste coming from operating rooms. We performed a waste audit of hip arthroscopy for femoroacetabular impingement (FAI) to understand its environmental impact and identify areas for greening practices. A waste audit of five hip arthroscopy procedures for FAI was performed. All waste was collected and separated into six waste streams in real time: (i) normal/landfill waste; (ii) recyclable cardboards and plastics; (iii) biohazard waste; (iv) sharp items; (v) linens and (vi) sterile wrapping...
July 2016: Journal of Hip Preservation Surgery
Benjamin G Domb, Kevin F Dunne, Timothy J Martin, Chengcheng Gui, Nathan A Finch, S Pavan Vemula, John M Redmond
Previous studies assessed elite athletes' return to sport (RTS) after hip arthroscopy, but few investigated a cohort including athletes from all levels of sport. This study compared athletes who returned to sport to those who did not, based on four patient-reported outcome (PRO) scores, including the Hip Outcome Score-Sports Specific Subscale (HOS-SSS). Between September 2008 and April 2012, hip arthroscopies were performed on 157 patients (168 hips) who reported playing a sport preoperatively and indicated their level of sports activity post-operatively...
July 2016: Journal of Hip Preservation Surgery
J W Thomas Byrd, Kay S Jones, Paul C Chin
Successful hip arthroscopy depends on proper patient selection and reasonable patient expectations. The purpose of this study is to report the results of hip arthroscopy in orthopaedic surgeons who represent the most informed cohort. This report is based on a retrospective review of prospectively collected data among 24 orthopaedic surgeons (1 bilateral). Follow-up averaged 48 months (range 12-120 months). They were all males with an average age of 45 years (range 30-64 years). All improved with an average of 18 points (preoperative 75; post-operative 93); although one underwent repeat arthroscopy and one was converted to total hip arthroplasty at 54 months...
July 2016: Journal of Hip Preservation Surgery
R Wejnold Jørgensen, C Dippmann, L Dahl, J Stürup
BACKGROUND: The amount of patients referred with longstanding, non-arthritic hip pain is increasing, as are the treatment options. Left untreated hip dysplasia, acetabular retroversion and femoroacetabular impingement (FAI) may lead to osteoarthritis (OA). Finding the right treatment option for the right patient can be challenging in patients with non-arthritic hip pain. PURPOSE: The purpose of this study was to categorize the radiographic findings seen in patients with longstanding hip pain, suspect for an intraarticular pathology, and provide a treatment algorithm allocating a specific treatment option for each clinical condition...
2016: Open Orthopaedics Journal
Jason R Dutton, Nicholas A Kusenzov, Joseph T Lanzi, E'Stephan J Garcia, Mark P Pallis
PURPOSE: To examine the outcomes of arthroscopic treatment of the hip in a young, active military population. Specifically, the ability to return to duty was the prime indicator of success. In addition, an objective evaluation of various demographic and surgery-related variables was performed to identify predictors for success or failure of treatment in this military population. METHODS: A retrospective chart review was undertaken to ascertain the results of hip arthroscopy at a single academic military medical center...
August 23, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Brian M Capogna, Michael K Ryan, John P Begly, Kristofer E Chenard, Siddharth A Mahure, Thomas Youm
PURPOSE: To examine clinical outcomes and survivorship in patients aged 60 years or older who underwent hip arthroscopy for management of hip pain. METHODS: Prospectively collected data for patients 60 or older undergoing hip arthroscopy were obtained. All patients were indicated for hip arthroscopy based on standard preoperative examination as well as routine and advanced imaging. Demographic data, diagnosis, and details regarding operative procedures were collected...
August 17, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Yasuharu Nakashima, Masanori Fujii, Yasuo Noguchi, Kenya Suenaga, Takuaki Yamamoto, Jun-Ichi Fukushi, Goro Motomura, Satoshi Hamai, Daisuke Hara, Yukihide Iwamoto
OBJECTIVE: The purpose of this study was to clarify the minimum joint space width (MJSW) that leads to subchondral bone exposure (SBE) in patients with hip dysplasia. METHODS: We included 82 subjects (86 hips) who had hip dysplasia with center-edge angle less than 20° and who underwent periacetabular osteotomy combined with hip arthroscopy. The acetabular and femoral cartilages were divided into the three regions: anterosuperior, superior, and posterosuperior; for each region, we analyzed the correlation between the incidence of SBE and the MJSW measured on plain radiographs...
August 19, 2016: Modern Rheumatology
Vivek Chadayammuri, Cecilia Pascual-Garrido, Tigran Garabekyan, Matthew J Kraeutler, Kenneth Milligan, Asheesh Bedi, Omer Mei-Dan
The purpose of this study was to investigate the effect of general anesthesia on preoperative passive hip range of motion (ROM) in patients undergoing hip arthroscopy for various indications. A total of 260 consecutive patients undergoing hip arthroscopy were included in this study. Passive hip ROM was evaluated bilaterally in the clinic and subsequently under general anesthesia immediately preoperatively. Demographic variables, including age, height, weight, and clinical diagnosis, were recorded for all patients...
August 18, 2016: Orthopedics
Allan Gross, Jeffrey M Muir
Osteoarthritis is a ubiquitous condition, affecting 26 million Americans each year, with up to 17% of adults over age 75 suffering from one variation of arthritis. The hip is one of the most commonly affected joints and while there are conservative options for treatment, as symptoms progress, many patients eventually turn to surgery to manage their pain and dysfunction. Early surgical options such as osteotomy or arthroscopy are reserved for younger, more active patients with less severe disease and symptoms...
September 2016: Medical Hypotheses
Kevin J DiSilvestro, Adam J Santoro, Fotios P Tjoumakaris, Eric A Levicoff, Kevin B Freedman
BACKGROUND: Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive...
August 4, 2016: Clinical Orthopaedics and related Research
Darrin J Trask, James S Keene
BACKGROUND: Data on the efficacy of microfracture for treatment of chondral defects in the hip are currently limited, and the recommended criteria for its use (minimal osteoarthritis; a focal, contained lesion <4 cm(2) in size) have been taken from those that were established for the knee. PURPOSE: To determine if the current microfracture (ie, knee) criteria are appropriate for chondral lesions in the hip. STUDY DESIGN: Case series; Level of evidence, 4...
July 27, 2016: American Journal of Sports Medicine
Vybhav Jetty, Charles J Glueck, Richard A Freiberg, Ping Wang
Venous thromboembolism is uncommon after knee arthroscopy, and there are no guidelines for thromboprophylaxis in elective routine knee arthroscopy. Preoperative evaluation of common thrombophilias should provide guidance for postarthroscopy thromboprophylaxis in otherwise healthy patients who are at high risk for venous thromboembolism. This study assessed 10 patients with venous thromboembolism after total hip or knee arthroplasty. Patients were assessed if venous thromboembolism occurred within 6 months after knee arthroscopy (n=10) or total hip or knee arthroplasty (n=21)...
July 25, 2016: Orthopedics
Zachary T Sharfman, Eyal Amar, Oren Tsvieli, Nassim Alkrinawi, Ofer Levy, Ehud Rath
BACKGROUND: In recent years, hip arthroscopy has rapidly evolved, offering patients evidence-based interventions with the merits of minimally invasive surgery and a relatively short rehabilitation period. Although considered a safe procedure, hip arthroscopy has associated complications that may be underreported depending on how patients are asked about their complications. PURPOSE: The aim of this study was to evaluate hip arthroscopy complications from the patient's perspective...
July 2016: Orthopaedic Nursing
David E Hartigan, Itay Perets, John P Walsh, Mary R Close, Benjamin G Domb
BACKGROUND: Symptomatic global retroversion of the acetabulum, as diagnosed on plain radiographs of the pelvis, has traditionally been treated with reverse periacetabular osteotomy, which improves posterior undercoverage and eliminates the anterior pincer lesion. There is a paucity of literature on hip arthroscopy in this group, secondary to theoretical concern of iatrogenic dysplasia, subsequent instability, and arthritis. PURPOSE: To evaluate the outcomes of hip arthroscopy for patients with a radiographic diagnosis of acetabular retroversion, using patient-reported outcomes, visual analog scale (VAS), patient satisfaction, and pre- and postoperative Tönnis grades...
October 2016: American Journal of Sports Medicine
Andrew J Bryan, Aaron J Krych, Ayoosh Pareek, Patrick J Reardon, Rebecca Berardelli, Bruce A Levy
BACKGROUND: Hip arthroscopy for young patients with femoroacetabular impingement (FAI) has been successful, but the efficacy of hip arthroscopy in older patients is not clearly defined. PURPOSE: To evaluate the clinical outcomes of patients 55 years and older who are undergoing hip arthroscopy and to compare outcomes with those of patients younger than 55 years. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 201 (63 male, 138 female) patients undergoing primary hip arthroscopy for FAI without radiographic arthritis (Tönnis grade <3) were isolated from a prospective database and stratified by age to <55-year and ≥55-year groups...
July 14, 2016: American Journal of Sports Medicine
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