Persistently elevated joint contact stress after periacetabular osteotomy is associated with joint failure at minimum 10-year follow-up.

Periacetabular osteotomy (PAO) is a common treatment for prearthritic hip dysplasia. The goal of this investigation was to determine if computationally assessed hip contact mechanics are associated with joint failure at minimum 10-year follow-up. One hundred patients with hip dysplasia (125 hips) completed patient-reported outcomes an average of 13.

Menstrual Cycle Hormone Relaxin and ACL Injuries in Female Athletes: A Systematic Review.

Background: Female athletes are at increased risk for anterior cruciate ligament (ACL) injuries. The influence of hormonal variation on female ACL injury risk remains ill-defined. Recent data suggests that the collagen-degrading menstrual hormone relaxin may cyclically impact female ACL tissue quality.

Editorial Commentary: Complications After Meniscal Surgery Are Rare and Generally Associated With Medical Comorbidity.

Meniscal tears are prevalent and frequently require surgical intervention. This injury affects younger, active patients after acute trauma. Meniscal repair is often indicated.

Arthroscopic Decompression of the Anterior Inferior Iliac Spine.

Background: Pathologic contact between the femoral neck and anterior inferior iliac spine (AIIS or subspine) often occurs concomitantly with femoroacetabular impingement, contributing to hip pain and dysfunction. We perform arthroscopic AIIS decompression to alleviate this source of extra-articular impingement and eliminate a potential cause of persistent pain following primary hip arthroscopy.

Description: After identifying abnormal AIIS morphology on preoperative false-profile radiographs and/or 3D computed tomography, we utilize a beaver blade to make a small incision in the proximal capsule and rectus femoris tendon.

Incorporating patient-specific hip orientation from weightbearing computed tomography affects discrete element analysis-computed regional joint contact mechanics in individuals treated with periacetabular osteotomy for hip dysplasia.

Computational models of the hip often omit patient-specific functional orientation when placing imaging-derived bony geometry into anatomic landmark-based coordinate systems for application of joint loading schemes. The purpose of this study was to determine if this omission meaningfully alters computed contact mechanics. Discrete element analysis models were created from non-weightbearing (NWB) clinical CT scans of 10 hip dysplasia patients (11 hips) and oriented in the International Society of Biomechanics (ISB) coordinate system (NWB-ISB).

The Incidence and Outcomes Following Treatment of Capsulolabral Adhesions in Hip Arthroscopy: A Systematic Review.

Background: To perform a systematic review to evaluate the incidence of capsulolabral adhesions following hip arthroscopy (HA) for femoroacetabular impingement (FAI); including risk factors and post-treatment outcomes.

Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we queried PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for English-language studies with minimum 6-month follow-up after primary or revision HA for FAI, which reported the incidence of capsulolabral adhesions. Potential adhesion risk factors, such as anchor type used and protocol for capsule closure, were assessed.

Sex Differences in Patient-Reported Outcomes Following Surgical Hip Preservation Interventions: A Systematic Review and Meta-Analysis.

Background: Female patients undergoing hip preservation surgery often have inferior patient-reported outcome scores (PROs), raising concerns about the clinical benefit of hip preservation surgery in women. Comparison of preoperative and postoperative PROs, and change in PROs, for female versus (vs.) male hip preservation patients was completed via systematic review.

Postoperative Bracing after Medial Patellofemoral Ligament Reconstruction.

It is unclear if bracing is necessary after isolated medial patellofemoral ligament reconstruction (MPFLr) for recurrent patellar instability. We hypothesize that patients who did not use a brace will have similar outcomes to those who were braced postoperatively. A retrospective review of patients who underwent isolated MPFLr from January 2015 to September 2020 at a single institution was performed.

Evaluation and Management of the Athlete's Hip.

Hip and groin pain is common in athletes, and there are many possible underlying pathologies. It is important to describe athletic hip pathology in the context of sport-specific physiologic loads and biomechanical demands. Three distinct types of athletes with this pathology are collision athletes, hypermobility athletes, and endurance athletes.

Providing a computationally derived, mechanically optimised target correction during preoperative planning can improve joint contact mechanics of hip dysplasia treated with periacetabular osteotomy.

Aim: Preoperative identification of acetabular corrections that optimally improve joint stability and reduce elevated contact stresses could further reduce osteoarthritis progression in patients with hip dysplasia who are treated with periacetabular osteotomy (PAO). The purpose of this study was to investigate how providing patient-specific, mechanically optimal acetabular reorientations to the surgeon during preoperative planning affected the surgically achieved correction.

Methods: Preoperative CT scans were used to create patient-specific hip models for 6 patients scheduled for PAO.

The Impact of Age on Clinical Outcomes of Acetabular Microfracture During FAI Surgery.

Background: Full-thickness acetabular cartilage lesions are common findings during primary surgical treatment of femoroacetabular impingement (FAI).

Purpose: To evaluate clinical outcomes after acetabular microfracture performed during FAI surgery in a prospective, multicenter cohort.

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

Return to Sport After Knee Injuries in Collegiate Wrestling.

Background: Wrestling is known to be a sport of relatively high injury incidence, and knee injuries account for a large percentage of those injuries. Treatment of these injuries varies considerably depending on injury and wrestler characteristics, leading to variability in complete recovery and return to sport (RTS). The purpose of this study was to evaluate injury trends, treatment strategies, and RTS characteristics after knee injuries in competitive collegiate wrestling.

Radiographically successful periacetabular osteotomy does not achieve optimal contact mechanics in dysplastic hips.

Background: Optimal correction of hip dysplasia via periacetabular osteotomy may reduce osteoarthritis development by reducing damaging contact stress. The objective of this study was to computationally determine if patient-specific acetabular corrections that optimize contact mechanics can improve upon contact mechanics resulting from clinically successful, surgically achieved corrections.

Methods: Preoperative and postoperative hip models were retrospectively created from CT scans of 20 dysplasia patients treated with periacetabular osteotomy.

Can Patients Read, Understand, and Act on Online Resources for Anterior Cruciate Ligament Surgery?

Background: Patients undergoing elective procedures often utilize online educational materials to familiarize themselves with the surgical procedure and expected postoperative recovery. While the Internet is easily accessible and ubiquitous today, the ability of patients to read, understand, and act on these materials is unknown.

Purpose: To evaluate online resources about anterior cruciate ligament (ACL) surgery utilizing measures of readability, understandability, and actionability.

FEAR index in predicting treatment among patients with femoroacetabular impingement and hip dysplasia and the relationship of femoral version.

The Femoro-Epiphyseal Acetabular Roof (FEAR) index is a newer measurement to identify the hip instability with borderline acetabular dysplasia. The purpose of this study is to (i) validate the FEAR index in determining the stability of the hip in patients who have previously been treated surgically for femoroacetabular impingement (FAI) and/or developmental dysplasia of the hip (DDH) and (ii) to examine the relationship between the FEAR index and femoral version, lateral center edge angle, Tönnis angle and alpha angle (AA). Patient demographics and radiographic measurements of 215 hips (178 patients), 116 hips treated with hip arthroscopy for FAI and 99 hips treated with periacetabular osteotomy (PAO) for DDH were compared between groups.

Outcomes Following Primary Anterior Cruciate Ligament Reconstruction Using a Partial Transphyseal (Over-the-Top) Technique in Skeletally Immature Patients.

Background: The incidence of anterior cruciate ligament (ACL) injuries in skeletally immature patients is increasing, with ACL reconstruction preferred in this population due to reported chondroprotective benefits. Due to concerns with growth disturbance following ACL reconstruction in skeletally immature patients, various physealsparing and partial transphyseal techniques have been developed. Currently, there is no consensus on the most effective ACL reconstruction technique in skeletally immature patients.

Effect of modeling femoral version and head-neck offset correction on computed contact mechanics in dysplastic hips treated with periacetabular osteotomy.

While correction of dysplastic acetabular deformity has been a focus of both clinical treatment and research, concurrent femoral deformities have only more recently received serious attention. The purpose of this study was to determine how including abnormalities in femoral head-neck offset and femoral version alter computationally derived contact stresses in patients with combined dysplasia and femoroacetabular impingement (FAI). Hip models with patient-specific bony anatomy were created from preoperative and postoperative CT scans of 20 hips treated with periacetabular osteotomy and femoral osteochondroplasty.

Do Relaxin Levels Impact Hip Injury Incidence in Women? A Scoping Review.

Purpose: The aim of this review is to assess the current evidence regarding the impact of relaxin on incidence of soft tissue hip injuries in women.

Methods: A trained research librarian assisted with searches of PubMed, Embase, CINAHL, and SPORTDiscus, with a preset English language filter. The review was completed per the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis methodology.

Risk Factors for Composite Failure of Hip Dysplasia Treated With Periacetabular Osteotomy: A Minimum 10-Year Follow-up.

Introduction: Periacetabular osteotomy (PAO) is a common surgical treatment of prearthritic hip dysplasia in young adults, but there are few long-term studies of clinical outcomes. The purpose of this investigation was to report a minimum 10-year clinical follow-up of hip dysplasia treated with PAO and identify risk factors for composite failure.

Methods: We identified 151 patients (198 hips) who underwent PAO to treat hip dysplasia at a single institution.

Calculating Intraoperative Fluid Deficit to Prevent Abdominal Compartment Syndrome in Hip Arthroscopy.

Abdominal compartment syndrome (ACS) is a rare but potentially fatal complication that can occur during hip arthroscopy. This usually occurs as a result of arthroscopic fluid passing into the retroperitoneal space through the psoas tunnel. From the retroperitoneal space, the fluid can then enter the intraperitoneal space through defects in the peritoneum.

Chronically elevated contact stress exposure correlates with intra-articular cartilage degeneration in patients with concurrent acetabular dysplasia and femoroacetabular impingement.

Hip dysplasia is known to lead to premature osteoarthritis. Computational models of joint mechanics have documented elevated contact stresses in dysplastic hips, but elevated stress has not been directly associated with regional cartilage degeneration. The purpose of this study was to determine if a relationship exists between elevated contact stress and intra-articular cartilage damage in patients with symptomatic dysplasia and femoroacetabular impingement.