Basic Hip Arthroscopy Part 2: Central Compartment Arthroscopy (Interportal Capsulotomy, Acetabuloplasty, and Labral Repair).

Over the past decade, hip-preservation strategies have gained momentum, resulting in a notable increase in the use of hip arthroscopy for diagnostic and therapeutic interventions in hip-related pathology. In this 3-part series, the authors will aim to comprehensively review the fundamentals of hip arthroscopy in the setting of femoroacetabular impingement. This Technical Note will thoroughly review the senior authors' approach to managing the central compartment of the hip in the context of femoroacetabular impingement.

Basic Hip Arthroscopy Part 1: Patient Positioning and Portal Placement.

Over the past decade, hip-preservation strategies have gained momentum, resulting in a notable increase in the use of hip arthroscopy for diagnostic and therapeutic interventions in hip-related pathology. In this 3-part series, the authors will aim to comprehensively review the fundamentals of hip arthroscopy in the setting of femoroacetabular impingement. While considering the advantages and disadvantages of post versus postless hip arthroscopy, this Technical Note will review the preferred patient and portal positioning approach used by the senior authors.

Basic Hip Arthroscopy Part 3: Peripheral-Compartment Arthroscopy (T-Capsulotomy, Femoroplasty, and Capsular Closure).

Over the past decade, hip preservation strategies have gained momentum, resulting in a notable increase in the use of hip arthroscopy for diagnostic and therapeutic interventions for hip-related pathology. In this 3-part series, we aim to comprehensively review the fundamentals of hip arthroscopy in the setting of femoroacetabular impingement. This Technical Note will thoroughly review the senior authors' approach to managing the peripheral compartment of the hip in the context of femoroacetabular impingement.

Demographic Disparities and Outcomes Following Hip Arthroscopy: Exploring the Impact of Social Determinants of Health in Femoroacetabular Impingement Syndrome.

Background: The purpose of this study was to explore the impact of social deprivation on preoperative characteristics and postoperative outcomes following hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS).

Methods: Patients undergoing primary HA for FAIS were identified, and their social deprivation index (SDI) score was assigned on the basis of the provided ZIP code. Quartiles (Q1 to Q4) were established using national percentiles, with Q4 representing patients from the areas of greatest deprivation.

The Association of Preoperative Hip Pain Duration With Delayed Achievement of Clinically Significant Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement Syndrome.

Background: Patients with hip pain ≥2 years before hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) have been shown to achieve inferior short-term and midterm outcomes compared with patients with a shorter pain duration, although there is limited literature that has evaluated the time to achieve clinically significant outcomes (CSOs) in this population.

Purpose: To compare the time to achieve CSOs after hip arthroscopic surgery for FAIS in patients with and without prolonged hip pain and to identify independent predictors of the delayed achievement of CSOs.

Study Design: Cohort study; Level of evidence, 3.

Treatment of Hip Cartilage Defects in Athletes.

Chondral defects in the athlete's hip are a relatively common occurrence, often presenting with debilitating pain and activity limitation. Preoperative identification of cartilage defects is challenging and there are many different modalities for treatment. Nonsurgical interventions, including activity modification, physical therapy, and injections, play a vital role, especially in less severe cases and as adjuncts to surgical intervention.

Primary and Revision Hip Arthroscopy in Borderline Hip Dysplasia Shows Comparable Outcomes at a Minimum 5-Year Follow-Up.

Purpose: To compare patient-reported outcomes (PROs), achievement of clinically significant outcomes, and reoperation-free survivorship between primary and revision hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) in propensity-matched borderline hip dysplasia (BHD) patients at a minimum 5-year follow-up.

Methods: Patients with BHD, characterized by a lateral center-edge angle 18° to 25°, who underwent HA for FAIS with capsular repair by a single surgeon between January 2012 and June 2018 with a minimum 5-year follow-up were identified. Cases of revision HA were propensity-matched 1:2 to cases of primary HA, controlling for age, sex, and body mass index.

Hip Arthroscopy Patients With Lower Back Pain Show Delayed Clinical Improvement and Inferior Time-Dependent Survivorship: A Propensity Matched Study at Mid-Term Follow-Up.

Purpose: To evaluate patient-reported outcomes (PROs) and survivorship at mid-term follow-up after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) in patients with and without preoperative lower back pain (LBP).

Methods: Patients with self-endorsed preoperative LBP who underwent HA for FAIS with mid-term follow-up were identified and propensity matched 1:1 to patients without back pain by age, sex, and body mass index (BMI). PROs collected preoperatively and at postoperative years 1, 2, and 5 included Hip Outcome Score-Activities of Daily Living (HOS-ADL) and Hip Outcome Score-Sports Subscale (HOS-SS), 12-item International Hip Outcome Tool (iHOT-12), modified Harris Hip Score (mHHS), and Visual Analog Scale (VAS) for Pain.

Outcomes of Flexibility Sport Athletes With Borderline Hip Dysplasia After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Propensity-Matched Analysis at Minimum 2-Year Follow-up.

Background: Hip arthroscopy has proved successful in treating femoroacetabular impingement syndrome (FAIS) in patients with and without borderline hip dysplasia (BHD). Despite a high prevalence of BHD in patients who participate in sports with high flexibility requirements, a paucity of literature evaluates the efficacy of hip arthroscopy in treating FAIS in flexibility sport athletes with BHD.

Purpose: To compare minimum 2-year patient-reported outcomes (PROs) and achievement of clinically significant outcomes in flexibility sport athletes with BHD undergoing primary hip arthroscopy for FAIS with capsular plication with results in flexibility sport athletes without dysplasia.

The Promising 2-Year Performance of the Patient-Reported Outcomes Measurement Information System in Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Background: Minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds have been previously defined for the Patient-Reported Outcomes Measurement Information System (PROMIS) at 1-year follow-up in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome; however, the MCID and PASS thresholds are yet to be defined for the PROMIS at 2-year follow-up.

Purpose: (1) To establish MCID and PASS thresholds for the PROMIS Pain Interference (PROMIS-PI) and PROMIS Physical Function (PROMIS-PF) at 2-year follow-up and (2) to correlate PROMIS scores with hip-specific patient-reported outcome measure (PROM) scores.

Study Design: Cohort study (diagnosis); Level of evidence, 3.

Orthopaedic Surgery Residency: Perspective of Applicants and Program Directors on Medical Student Virtual Experiences.

Introduction: Orthopaedic Residency Directors advised against visiting subinternship rotations in the peak of the pandemic. To adapt, programs offered multiple virtual experiences. The purpose of this study was to evaluate programs and applicants perceptions regarding the value of virtual experiences during the 2020 to 2021 application cycle and their utility in future application cycles.

Factors Associated With Increasing Length of Stay for Rheumatoid Arthritis Patients Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty.

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are cost-effective procedures that decrease pain and improve health-related quality of life for patients with advanced symptomatic arthritis, including rheumatoid arthritis (RA). Patients with RA have a longer length of stay (LOS) after THA or TKA than patients with osteoarthritis, yet the factors contributing to LOS have not been investigated. : We sought to identify the factors contributing to LOS for patients with RA undergoing THA and TKA at a single tertiary care orthopedic specialty hospital.

Emerging Racial Disparities in Outpatient Utilization of Total Joint Arthroplasty.

Background: Racial and ethnic disparities within the field of total joint arthroplasty (TJA) have been extensively reported. To date, however, it remains unknown how these disparities have translated to the outpatient TJA (OP-TJA) setting. The purposes of this study were to compare relative OP-TJA utilization rates between White and Black patients from 2011-2019 and assess how these differences in utilization have evolved over time.

Periprosthetic Tibial Plateau Fractures After Unicompartmental Knee Arthroplasty Are Successfully Treated With Open Reduction and Internal Fixation.

Periprosthetic tibial fractures after unicompartmental knee arthroplasty (UKA) are rare but devastating events. Given the relative infrequency of these injuries, treatment strategies are not well defined. The goal of this retrospective case series is to report the findings for a series of patients who underwent open reduction and internal fixation (ORIF) of periprosthetic fracture after UKA, including radiographic alignment, Knee Society Score (KSS), and failure rate.

Return to Performance After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers: A Case-Control Assessment of Advanced Analytics, Velocity, Spin Rates, and Pitch Movement.

Background: There are limited data on the performance or pitching metrics of Major League Baseball (MLB) pitchers who returned to play after ulnar collateral ligament reconstruction (UCLR).

Purpose: To describe MLB pitcher performance after return from primary UCLR, compare the velocity and pitch characteristics against the preoperative season, and determine if performance analytics can predict successful return to pitching after UCLR.

Study Design: Case-control study; Level of evidence, 3.

Risk Factors for Failure After Osteochondral Allograft Transplantation of the Knee: A Systematic Review and Exploratory Meta-analysis.

Background: Graft failure after osteochondral allograft transplantation (OCA) of the knee is a devastating outcome, often necessitating subsequent interventions. A comprehensive understanding of the risk factors for failure after OCA of the knee may provide enhanced prognostic data for the knee surgeon and facilitate more informed shared decision-making discussions before surgery.

Purpose: To perform a systematic review and meta-analysis of risk factors associated with graft failure after OCA of the knee.

The journey to preventing dislocation after total hip arthroplasty : how did we get here?

Dislocation following total hip arthroplasty (THA) is a well-known and potentially devastating complication. Clinicians have used many strategies in attempts to prevent dislocation since the introduction of THA. While the importance of postoperative care cannot be ignored, particular emphasis has been placed on preoperative planning in the prevention of dislocation.

Arthroscopic distal clavicle excision is associated with fewer postoperative complications than open.

Background: The rate of complications of open compared to arthroscopic distal clavicle excision remain poorly studied. Therefore, the purpose of this investigation was to (1) Identify most recent national trends in the usage of open vs. arthroscopic approaches for distal clavicle excision (DCE) from 2007 to 2017; (2) to identify and compare the complication rates for both approaches, and to identify patient-specific risk factors for complications; (3) to identify and compare the revision rate for both approaches; and (4) to identify and compare the reimbursement of each approach.

Anteriorizing Tibial Tubercle Osteotomy for Patellofemoral Cartilage Lesions.

Patellofemoral chondral lesions are common and can lead to significant pain. A tibial tubercle osteotomy (TTO) functions to mechanically unload the patellofemoral joint and improve the clinical success of cartilage restoration procedures. The type of TTO performed is based on several factors.

Elbow varus torque and ball velocity associations in high school and professional pitchers with increased sagittal-plane trunk tilt.

Background: Increased sagittal-plane trunk tilt is thought to increase drive in the anterior direction toward home plate, transferring energy from the trunk to the distal upper extremity, ultimately generating greater ball velocity. Increased sagittal trunk tilt has also been implicated in the risk of upper-extremity joint loading in baseball pitchers by way of elbow varus torque (EVT), a metric previously associated with elbow injury in professional pitchers. The purposes of this study were (1) to compare sagittal trunk tilt positioning between high school and professional pitchers throughout the pitch and (2) to identify the potential associations between sagittal-plane trunk tilt, ball velocity, and EVT for both cohorts.

Self-reported allergies correlate with a worse patient-reported outcome after hip arthroscopy: a matched control study.

Patient-reported outcome measures (PROMs) in patients with and without at least one self-reported allergy undergoing hip arthroscopy were compared. Data on 1434 cases were retrospectively reviewed, and 267 patients were identified with at least one self-reported allergy and randomly matched to a control group on a 1:2 ratio. Four PROMs [Modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports (HOS-Sport) and 33-item International Hip Outcome Tool (iHOT-33)] were collected preoperatively, and at 5-11, 12-23 and 24-35 months postoperatively.

Do Medical Students Who Participate in a Research Gap Year Produce More Research During Residency?

Background: The research gap year has become increasingly popular among medical students. It is also a well-known factor in consideration for orthopaedic surgery residency programs. Although medical students who participated in a research gap year typically enter residency with more research experience than their counterparts, it is unknown whether this translates to increased research productivity during residency compared with their peers.