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Hip arthroscopy

Jung-Mo Hwang, Deuk-Soo Hwang, Woo-Yong Lee, Chang-Kyun Noh, Long Zheng
Traumatic hip fracture-dislocations are associated with chondral and labral pathology as well as loose bodies that can be incarcerated in the hip joint. Incarceration, such as interposed labrum between acetabulum and femoral head that is not readily visualized preoperatively, is a rare but important cause of pain and can potentially be a source for early degeneration and progression to osteoarthritis. We present three cases, arthroscopic surgery of incarcerated acetabular osseo-labral fragment following reduction of traumatic hip fracture-dislocation...
September 2016: Hip Pelvis
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
So Minokawa, Masatoshi Naito, Koichi Kinoshita, Takuaki Yamamoto
BACKGROUND: The vascular supply to the acetabular labrum is important in the treatment of labral lesions. However, in vivo blood flow measurements in the acetabular labrum have not been described in the literature. The purpose of this study was to examine this blood flow in vivo using laser Doppler flowmetry (LDF) in patients with acetabular dysplasia. METHODS: Periacetabular osteotomy combined with arthroscopy was performed in 47 consecutive patients (three males, 44 females; mean age at surgery, 35...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Roberto Seijas, Andrea Sallent, María Galán, Pedro Alvarez-Diaz, Oscar Ares, Ramón Cugat
BACKGROUND: Hip arthroscopy is considered a safe procedure, considering the relatively low rate of complications. Despite several complications have been described following this surgical procedure, the present event has not yet been described. The purpose of the present study is to report an unpublished complication following hip arthroscopy, after reviewing 162 hip arthroscopies and finding iliotibial band syndrome (ITBS) in the knee during followup. MATERIALS AND METHODS: A retrospective review of 162 hip arthroscopies performed between September 2007 and June 2011 was carried out, evaluating patients who presented ITBS during followup...
September 2016: Indian Journal of Orthopaedics
Dagang Zhang, Long Chen, Guanglin Wang
BACKGROUND: This meta-analysis aims to evaluate the efficacy and safety of hip arthroscopy versus open surgical dislocation for treating femoroacetabular impingement (FAI) through published clinical trials. METHODS: We conducted a comprehensive literature search using PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials databases for relevant studies on hip arthroscopy and open surgical dislocation as treatment options for FAI. RESULTS: Compared with open surgical dislocation, hip arthroscopy resulted in significantly higher Nonarthritic Hip Scores (NAHS) at 3- and 12-month follow-ups, a significant improvement in NAHS from preoperation to 3 months postoperation, and a significantly lower reoperation rate...
October 2016: Medicine (Baltimore)
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
Brian J White, Julie Patterson, Mackenzie M Herzog
PURPOSE: To compare the outcome of labral repair versus labral reconstruction in patients presenting to a single surgeon for revision hip arthroscopy following previous labral treatment. METHODS: Patients who underwent revision labral repair or labral reconstruction using iliotibial band allograft, after previous labral debridement or repair, between 2009 and 2013 were identified. Hips that underwent revision labral reconstruction were further stratified into 2 graft groups (freeze-dried v frozen allograft)...
October 5, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alexander E Weber, Benjamin D Kuhns, Gregory L Cvetanovich, Paul B Lewis, Richard C Mather, Michael J Salata, Shane J Nho
PURPOSE: The purpose of this study was to examine the hip capsule in a subset of symptomatic patients who underwent capsular closure during hip arthroscopy. METHODS: All patients undergoing primary hip arthroscopy for femoroacetabular impingement (FAI) with routine capsular closure between January 1, 2012, and December 31, 2015, were eligible. Only patients with unilateral surgery and a postoperative magnetic resonance imaging (MRI; ordered for persistent symptoms) were included...
October 5, 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
Florian Schmaranzer, Pascal C Haefeli, Markus S Hanke, Emanuel F Liechti, Stefan F Werlen, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) allows an objective, noninvasive, and longitudinal quantification of biochemical cartilage properties. Although dGEMRIC has been used to monitor the course of cartilage degeneration after periacetabular osteotomy (PAO) for correction of hip dysplasia, such longitudinal data are currently lacking for femoroacetabular impingement (FAI). QUESTIONS/PURPOSES: (1) How does the mean acetabular and femoral dGEMRIC index change after surgery for FAI at 1-year followup compared with a similar group of patients with FAI treated without surgery? (2) Does the regional distribution of the acetabular and femoral dGEMRIC index change for the two groups over time? (3) Is there a correlation between the baseline dGEMRIC index and the change of patient-reported outcome measures (PROMs) at 1-year followup? (4) Among those treated surgically, can dGEMRIC indices distinguish between intact and degenerated cartilage? METHODS: We performed a prospective, comparative, nonrandomized, longitudinal study...
October 5, 2016: Clinical Orthopaedics and related Research
Ryan Sauber, George Saborio, Beth M Nickel, Benjamin R Kivlan, John J Christoforetti
Advanced hip joint-preserving arthroscopic techniques have been shown to improve patient-reported functional outcomes with low rates of postoperative complications. Prior work has shown that formation of adhesive scar is a potential source of persistent pain and cause for revision surgery. As resources for postoperative in-studio physical therapy become scarce, a home-based strategy to avoid scar formation without adding formal therapy cost may be beneficial. The purpose of this technical note is to introduce a patient-centered educational video technique for home-caregiver delivery of manual hip pendulum exercises in the postoperative setting...
August 2016: Arthroscopy Techniques
Andrea M Spiker, Christopher L Camp, Brian T Barlow, Shawn G Anthony, Struan H Coleman
This article describes the use of sutures to enhance visualization while protecting the capsule in both the central and peripheral compartments during hip arthroscopy. We describe first a technique to preserve the proximal capsule cuff while working in the central compartment and then an alternative to the T-capsulotomy while maintaining excellent visualization of the peripheral compartment during femoroplasty of cam-type femoroacetabular impingement. By use of suture suspension of the capsule, multiple goals are achieved: The integrity of the proximal capsule cuff is maintained while aiding in visualization of the central compartment; the iliofemoral ligament is spared, which plays a critical role in preventing microinstability; the necessary space is created to obtain adequate visualization of the peripheral compartment for complete femoroplasty; and operative time is reduced because creation and subsequent repair of the T-capsulotomy can be avoided...
August 2016: Arthroscopy Techniques
Tanya Keough, David Wilson, Ivan Wong
Over the past 2 decades, hip arthroscopy has developed as a surgical technique, with more orthopaedic surgeons attempting to become proficient in performing this surgical procedure as indications and surgical skills evolve. The hip joint presents unique arthroscopic challenges because of its anatomic location, and it can be challenging to safely and confidently establish portal sites. Ultrasound-guided hip arthroscopy portal placement is not yet common practice for orthopaedic surgeons. The potential advantages of ultrasound-guided hip arthroscopy portal placement are the lack of radiation exposure to the patient and operating room personnel, direct visualization of the hip joint and surrounding soft-tissue structures, and lack of bulky fluoroscopic equipment in the operative field...
August 2016: Arthroscopy Techniques
Martin Ellenrieder, Thomas Tischer, Rainer Bader, Peter Cornelius Kreuz, Wolfram Mittelmeier
INTRODUCTION: The application of traction in hip arthroscopy is associated with peri-operative complications. Within a therapeutic case series, patient-related factors correlating with high-traction forces during hip arthroscopy and occurring complications should be identified. MATERIALS AND METHODS: In 30 male and 38 female patients (mean age: 44.5 years), intra-operative traction forces were monitored continuously using a specialised measurement device. A multivariate analysis was employed to identify patient-related factors influencing the traction force...
September 30, 2016: Archives of Orthopaedic and Trauma Surgery
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
A Martínez-Martínez, J García-Espinosa, F Ruiz-Santiago, L Guzmán-Álvarez, M M Castellano-García
OBJECTIVE: To evaluate the usefulness of ultrasound-guided versus fluoroscopy-guided injection in CT arthrography and MR arthrography. MATERIAL AND METHODS: We reviewed all CT arthrography and MR arthrography studies done at our center between October 1, 2014 and October 1, 2015. We analyzed 32 studies: 26 with fluoroscopic guidance and 6 with ultrasound guidance. We compared the two techniques on the following parameters: presence of sufficient contrast material in the joint, extravasation or injection of contrast material in the soft tissues (presence of contrast material in the psoas or other soft tissues), and intra-articular gas bubbles...
September 27, 2016: Radiología
D R Griffin, E J Dickenson, J O'Donnell, R Agricola, T Awan, M Beck, J C Clohisy, H P Dijkstra, E Falvey, M Gimpel, R S Hinman, P Hölmich, A Kassarjian, H D Martin, R Martin, R C Mather, M J Philippon, M P Reiman, A Takla, K Thorborg, S Walker, A Weir, K L Bennell
The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June...
October 2016: British Journal of Sports Medicine
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
David M Levy, Benjamin D Kuhns, Rachel M Frank, Jeffrey S Grzybowski, Kirk A Campbell, Sara Brown, Shane J Nho
BACKGROUND: Femoroacetabular impingement (FAI) is most commonly diagnosed in athletes who sustain repetitive flexion loading to their hips. No studies to date have focused solely on patients' return-to-running ability after hip arthroscopy. PURPOSE: To evaluate patients' ability to return to running after hip arthroscopy for FAI and capsular plication. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Clinical data were retrospectively retrieved for 51 consecutive patients with FAI (22 men, 29 women) who had undergone hip arthroscopy for the treatment of FAI and identified themselves as recreational or competitive runners on intake forms...
September 12, 2016: American Journal of Sports Medicine
Eric W Edmonds, Christina Lin, Christine L Farnsworth, James D Bomar, Vidyadhar V Upasani
BACKGROUND: Prompt open arthrotomy is historically utilized to treat pediatric septic arthritis of the hip, but arthroscopy has been described as a valid alternative to prevent long-term sequelae. Standard hip arthroscopy in adolescents and adults utilizes lateral-based portals, but successful irrigation in infants may necessitate a medial portal due to the smaller joint size. The purpose of this study was to determine the safety of a medial hip portal in children based on its anatomic relation to neurovascular structures...
September 3, 2016: Journal of Pediatric Orthopedics
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