Persistent pain after hip arthroscopy may be due to residual impingement, hip dysplasia, osteoarthritis progression, labral injury, or insufficient capsular closure. A patient's history, physical examination findings, and imaging studies should be used to determine whether revision hip arthroscopy is indicated. If surgical management is chosen, careful preoperative planning is essential. During revision hip arthroscopy, the presence and location of adhesions should be considered during interportal capsulotomy and T-capsulotomy creation and while applying traction sutures. The presence of a residual cam or pincer lesion and the adequacy of the labrum or labral graft should be assessed and properly addressed. If capsular redundancy is recognized, capsular plication may be performed. The purpose of this Technical Note is to describe an approach to revision hip arthroscopy for labral repair and residual cam lesion resection.
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http://dx.doi.org/10.1016/j.eats.2021.10.003 | DOI Listing |
Iowa Orthop J
January 2025
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Background: The use of intraoperative intra-articular morphine has been suggested to lower postoperative pain scores and opioid use. We sought to evaluate the effectiveness of intra-articular morphine with 0.75% ropivacaine when compared to the use of ropivacaine alone.
View Article and Find Full Text PDFIowa Orthop J
January 2025
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Background: Hip dysplasia diagnosed after skeletal maturity is distinct from developmental dysplasia of the hip (DDH) in infants and young children. While the natural history of DDH in infants and young children is well-established, the association between hip dysplasia diagnosed after skeletal maturity and osteoarthritis is less clear. This narrative review summarizes existing literature assessing characteristics of hip dysplasia diagnosed after skeletal maturity associated with progression to osteoarthritis.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
Department of Orthopedics, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
The correlation between clinical outcomes and preoperative/postoperative measures of the lateral center-edge angle (LCEA) will help establish the cutoff values for this measurement and determine whether to obtain it from the lateral acetabular rim (LCEAR) or the lateral end of the sourcil (LCEAS). The hypothesis was that the LCEAS would be more sensitive than the LCEAR. An upper cutoff value of LCEA could predict better functional outcomes in FAI patients.
View Article and Find Full Text PDFBMC Health Serv Res
January 2025
The University of Sydney, Faculty of Medicine and Health, School of Rural Health, Orange, NSW, 2800, Australia.
Background: Low-value care refers to the provision of health services that confer little or no benefit to patients, or have the potential to incur unwarranted harms. A breadth of literature exists investigating geographical variations in rates of potential low-value interventions for musculoskeletal pain. This scoping review aimed to examine the provision of low-value care for osteoarthritis and lower back pain by degree of rurality (e.
View Article and Find Full Text PDFArthroscopy
January 2025
Kansas City Orthopedic Alliance, 10777 Nall Avenue, Overland Park, KS 66224. Electronic address:
As surgeons, we strive to recognize and correct any mistakes that may occur before completing an operation, and importantly, do our best to avoid irreversible mistakes. Over-resection of the femoral cam lesion in patients having hip arthroscopy for femoroacetabular impingement syndrome has been considered irreversible. While cam under-resection is a technical complication of femoroacetabular impingement surgery to be avoided, avoiding this at the expense of over-resection of the proximal femur is of great concern.
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