Findings on repaired full-thickness acetabular articular cartilage defects during revision hip arthroscopy allowing a second look.

Full-thickness acetabular articular cartilage defects (FAACD) are found on most hips with femoroacetabular impingement (FAI) with a wave sign in the acetabulum. When not repaired it can produce pain and catching sensation. Multiple arthroscopic techniques for repairing this chondral lesion exist, but only few show the quality of the repair on a second look.

Editorial Commentary: Can We Derive Any Practical Information From a Study of "The Top 50 Most Influential Papers in Hip Arthroscopy," or Are We Tooting Our Own Horns?

Orthopaedic literature on hip arthroscopy has become more robust primarily from the advent and transformation in the treatment of femoroacetabular impingement syndrome from an open surgical dislocation to an ambulatory arthroscopic procedure. Numerous studies have reviewed the frequency of authors and subjects in particular areas of arthroscopy, but until this article, none had been performed on the most influential in hip arthroscopy. The question to be answered is, Do such studies contribute significantly to our knowledge by suggesting future topics to clinicians and training programs?

The anatomical properties of the indirect head of the rectus femoris tendon: a cadaveric study with clinical significance for labral reconstruction surgery.

Background: Acetabular labral tear is a common pathology. In some clinical situations, primary labral repair may not be possible and labral reconstruction is indicated.

Purpose And Clinical Relevance: Describe the anatomy of the indirect head of the rectus femoris (IHRF) tendon with clinical application in arthroscopic labral reconstruction surgery.

Editorial Commentary: What is the Real Story Behind "What Makes Suture Anchor Use Safe in Hip Arthroscopy?".

Reproducibly safe hip suture anchor placement requires clear visualization of the acetabular rim and acetabular articular cartilage and a correct trajectory when the anchor sites and position are selected and when depth stop drilling is done. I favor the lateral decubitus approach over the supine approach and do an extensive capsulotomy for global access to the central and peripheral compartments, thus requiring fewer distraction forces and minimal time spent in the central compartment. My views of the acetabular rim are obtained from the periphery most of the time, and as such, suture anchor drilling and placement are always visualized during simultaneous viewing of both the bony acetabular rim and articular cartilage; thus, the trajectory is targeted with clear visualization of the drill hole from the time of creation to anchor placement.

Incorporating Hip Arthroscopy Into A Practice.

Hip arthroscopy is one of the most rapidly growing areas in orthopaedic surgery because of increased awareness of nonarthritic hip pathologies, advanced imaging modalities, and advanced techniques to reproducibly manage nonarthritic hip pathologies within a deep soft-tissue envelope and a constrained joint. In addition, more academic medical centers are providing residents with education on hip arthroscopy, and many hip preservation fellowships and courses are helping increase awareness of nonarthritic hip pathologies. Nonarthritic hip pathologies currently managed via hip arthroscopy include nonrepairable labral lesions, femoroacetabular impingement, hip instability, and hip fractures.

Acetabular labral reconstruction using the indirect head of the rectus femoris tendon significantly improves patient reported outcomes.

Purpose And Hypothesis: The aim of this study was to evaluate outcomes after acetabular labral reconstruction using the indirect head of the rectus femoris tendon. The study hypothesis stated that arthroscopic acetabular labral reconstruction may improve patient reported outcomes in patients with labral tears that were not amenable to repair.

Methods: Between 2009 and 2015, the senior author performed 31 acetabular labral reconstructions using the indirect head of the rectus femoris tendon.

Arthroscopic Labrum Reconstruction in the Hip Using the Indirect Head of Rectus Femoris as a Local Graft: Surgical Technique.

The importance of the acetabular labrum has been well documented for the health and function of the hip joint. Labral reconstruction has proven effective but often requires the use of a cadaveric allograft or auto graft from the fascia lata or gracilis. The indirect head of the rectus femoris is in close proximity with the anterior superior acetabulum, which is the most common site of labral tears.

Hip Arthroscopy: Tales From the Crypt.

Complications after hip arthroscopy vary in frequency and severity, even for experienced surgeons. It is important for surgeons to be aware of some of the more dramatic, often unusual, and always memorable (nightmarish) complications of hip arthroscopy and understand how they are caused, how they can be treated, and how they can be prevented.

Arthroscopy of the nondistractable hip: a novel extracapsular approach.

Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy.

The regional microvascular density of the gluteus medius tendon determined by immunohistochemistry with CD31 staining: a cadaveric study.

Background And Purpose: There are no studies to date about the vascularisation into the gluteus medius tendon. The purpose of this study was to define the microvessel density of the gluteus medius in 3 zones through a special staining with CD31 and to identify regional differences in microvascular density that may have implications for the healing.

Methods: We obtained 12 complete gluteus medius tendons from cadavers who had been an average age of 30.

Capsular closure does not affect development of heterotopic ossification after hip arthroscopy.

Purpose: The purpose of this study was to evaluate the role of capsular closure after hip arthroscopy in reduction of the incidence of heterotopic ossification (HO).

Methods: One hundred (50 study group, 50 control group) consecutive hip arthroscopy procedures with radiographic follow-up of more than 9 weeks were included in the study. The study group consisted of 50 patients in whom capsular closure with 2 No.

The incidence of heterotopic ossification in hip arthroscopy.

Purpose: The purpose of this study was to assess the incidence of heterotopic ossification (HO) after hip arthroscopy.

Methods: Between July 2010 and July 2011, 83 patients underwent hip arthroscopy for various etiologies. We prospectively reviewed 50 consecutive hip arthroscopy procedures (31 male and 19 female patients; mean age, 36.

Intra-abdominal fluid extravasation during hip arthroscopy: a survey of the MAHORN group.

Purpose: The purpose of this study was to survey experts in the field of hip arthroscopy from the Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) group to determine the frequency of symptomatic intra-abdominal fluid extravasation (IAFE) after arthroscopic hip procedures, identify potential risk factors, and develop preventative measures and treatment strategies in the event of symptomatic IAFE.

Methods: A survey was sent to all members of the MAHORN group. Surveys collected data on general hip arthroscopy settings, including pump pressure and frequency of different hip arthroscopies performed, as well as details on cases of symptomatic IAFE.

The Development and validation of a self-administered quality-of-life outcome measure for young, active patients with symptomatic hip disease: the International Hip Outcome Tool (iHOT-33).

Purpose: The purpose of this study was to develop a self-administered evaluative tool to measure health-related quality of life in young, active patients with hip disorders.

Methods: This outcome measure was developed for active patients (aged 18 to 60 years, Tegner activity level ≥ 4) presenting with a variety of symptomatic hip conditions. This multicenter study recruited patients from international hip arthroscopy and arthroplasty surgeon practices.

Arthroscopic treatment for chondral lesions of the hip.

Arthroscopic treatment of chondral lesions of the hip is challenging. Understanding the etiology is paramount not only in treating hip chondral damage but also in mitigating the cause, using arthroscopic means. This article addresses chondral lesions of the hip caused by either injury or morphologic conflicts such as seen in femoroacetabular impingement.

The pattern and technique in the clinical evaluation of the adult hip: the common physical examination tests of hip specialists.

Purpose: The purpose of this study was to systematically evaluate the technique and tests used in the physical examination of the adult hip performed by multiple clinicians who regularly treat patients with hip problems and identify common physical examination patterns.

Methods: The subjects included 5 men and 6 women with a mean age (+/-SD) of 29.8 +/- 9.

A geographic zone method to describe intra-articular pathology in hip arthroscopy: cadaveric study and preliminary report.

Purpose: Our purpose was to develop an alternative method to divide the acetabulum and femoral head into different zones based on anatomic landmarks clearly visible during arthroscopy to facilitate reporting the geographic location of intra-articular injuries.

Methods: Two vertical lines are positioned across the acetabulum aligned with the anterior and posterior limits of the acetabular notch. A horizontal line is positioned aligned with the superior limit of the notch perpendicular to the previous lines.

Arthroscopic treatment of femoroacetabular impingement: a proposed technique with clinical experience.

Femoroacetabular impingement is a condition that primarily occurs in young and middle-aged adults. It is characterized by hip pain felt mostly in the groin. Radiographs often appear normal to the untrained observer; however, on careful analysis an anterior to lateral bump may be seen at the head-neck junction as an extension of the physeal line.