The increasing use of hip arthroscopy has been accompanied by an associated increase in revision hip arthroscopy. The results of revision surgery are generally inferior to primary hip arthroscopy. When revision hip arthroscopy fails, repeat revision hip arthroscopy may be indicated. Addressing the etiology of failure of the primary and first revision surgery is fundamental to achieving optimal outcomes in repeat revision cases. Unfortunately, poorly executed previous surgery is the leading etiology of failure, with unaddressed femoroacetabular impingement, labral damage, and capsular deficiency most commonly encountered during repeat revision surgery. Complex secondary soft-tissue procedures may be required to address capsular and labral deficiency from previous surgery. Despite clinically significant improvement in repeat revision cases, results are inferior to those after primary hip arthroscopy. The best opportunity for a patient to achieve an optimal outcome is a well-executed primary surgery.
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http://dx.doi.org/10.1016/j.arthro.2021.05.055 | DOI Listing |
J Hip Preserv Surg
July 2024
Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100000, China.
Orthop J Sports Med
January 2025
Pan Am Clinic and University of Manitoba, Winnipeg, Manitoba, Canada.
Background: Inconsistencies in the workup of labral tears in the hip have been shown to result in a delay in treatment and an increased cost to the medical system.
Purpose: To establish consensus statements among Canadian nonoperative/operative sports medicine physicians via a modified Delphi process on the diagnosis, nonoperative and operative management, and rehabilitation and return to play (RTP) of those with labral tears in the hip.
Study Design: A consensus statement.
Arthroscopy
January 2025
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Purpose: To determine the effectiveness of administering intravenous (IV) tranexamic acid (TXA) on altering visual field clarity (VFC) during arthroscopic hip preservation surgery for patients with femoroacetabular impingement syndrome (FAIS).
Methods: This randomized, double-blind, parallel-design trial was conducted over a seven-month period between October 2023 and May 2024 at a single tertiary musculoskeletal hospital. Inclusion criteria included consecutive patients that were diagnosed with FAIS through clinical history, physical exam and advanced imaging and indicated for hip arthroscopy after having failed conservative management.
Am J Sports Med
January 2025
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
Background: Intraoperative hip capsule management is increasingly recognized as an important component of hip arthroscopy for the prevention of capsular-related instability. The periportal capsulotomy, relative to the interportal capsulotomy, has been proposed as a minimally invasive technique for decreasing postarthroscopy hip instability; however, the biomechanical effects of this technique are not well established.
Purpose/hypothesis: This study aimed to provide a biomechanical characterization of interportal and periportal capsulotomies, helping inform surgeon choice of capsulotomy type and repair, potentially guiding clinical practice in hip arthroscopy.
Orthop J Sports Med
January 2025
Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, Washington, USA.
Background: Femoroacetabular impingement syndrome (FAIS) is frequently treated arthroscopically with osteoplasty and labral repair. Surgical preferences vary in terms of equipment, technique, and postoperative protocol. Patient-reported outcome measures (PROMs) are valuable tools to assess outcomes across different institutions.
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