Combined Transfer of the Gluteus Maximus and Tensor Fasciae Latae for Irreparable Gluteus Medius Tear Using Contemporary Techniques: Short-Term Outcomes.

Unlabelled: Combined transfer of the gluteus maximus and tensor fasciae latae (TFL) has been acknowledged as a treatment for irreparable full-thickness gluteus medius tears; yet, there is a paucity of reports on outcomes for this topic in the current literature. The purpose of the present study was to report short-term patient-reported outcome scores in patients who underwent combined transfer of the gluteus maximus and TFL in the setting of an irreparable gluteus medius tear.

Methods: Data for patients who underwent hip preservation and hip arthroplasty between July 2011 and November 2017 were prospectively collected and retrospectively reviewed.

Can Patient-Reported Outcomes Predict the Need for Secondary Surgeries After Hip Arthroscopy?

Background: Patient-reported outcomes (PROs) capture the postoperative period and reflect the patient's perspective of one's own recovery. However, it is unknown if PROs can reflect and predict the need for secondary surgeries after a primary hip arthroscopy.

Purpose: To examine if PROs at 3 months and 1 year after primary hip arthroscopy were correlated with future reoperations and determine the critical thresholds for significant PROs utilizing a multivariate logistic regression analysis and receiver operator characteristic (ROC) analysis.

Hip Arthroscopic Surgery in the Context of Femoroacetabular Impingement Syndrome, Labral Tear, and Acetabular Overcoverage: Minimum 5-Year Outcomes With a Subanalysis Against Patients Without Overcoverage.

Background: Improvement in patient-reported outcomes (PROs) has been reported in the short term after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear in the setting of acetabular overcoverage. Yet, there is a paucity of information in the literature on midterm PROs.

Purpose: To (1) report minimum 5-year PROs in patients who underwent primary hip arthroscopy for FAIS and acetabular labral tears in the context of acetabular overcoverage and (2) compare outcomes with those of a propensity-matched control group without acetabular overcoverage.

Mid- to Long-Term Outcomes of Hip Arthroscopy: A Systematic Review.

Purpose: To assess mid- to long-term patient-reported outcomes (PROs) of hip arthroscopy as well as the rates of secondary surgery and to identify indications for surgery and noted predictors of failure.

Methods: A systematic review of the current literature was performed with the terms "hip arthroscopy," "outcomes," "patient-reported outcomes," "mid-term," "5-year," "long-term," and "10-year" in the PubMed, Cochrane, and Embase databases in April of 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data for study characteristics, patient demographics, follow-up time, indications for surgery, PROs, predictors of failure or unfavorable PROs, and rates of secondary hip preservation surgery and conversion to total hip arthroplasty were collected.

Revision Hip Arthroscopy in the Borderline Dysplastic Population: Reporting Outcomes With Minimum 2-Year Follow-up, With a Subanalysis Against a Propensity-Matched Nondysplastic Control Group.

Background: Hip arthroscopy in patients with borderline dysplasia continues to be surrounded by controversy. Even more controversial is the management of the failed hip arthroscopy in this population. There is a paucity of studies in contemporary literature regarding outcomes after arthroscopic revision surgery.

How has arthroscopic management of the iliopsoas evolved, and why? A survey of high-volume arthroscopic hip surgeons.

The rapid growth of hip preservation has left surgeons following trends based on limited, or even anecdotal, evidence in certain circumstances. A consensus as well as high-level research on how best to manage the iliopsoas is lacking. Arthroscopic treatment of the iliopsoas may be an example of how treatment patterns and trends can shift with limited evidence-based medicine.

Does failure to meet threshold scores for mHHS and iHOT-12 correlate to secondary operations following hip arthroscopy?

The purpose of this study was to determine (i) if failing to achieve a patient-reported outcome (PRO) threshold at 1 year was associated with secondary operations at minimum 2-year follow-up and (ii)what outcome measure and threshold has the highest association with future surgeries. Inclusion criteria for this study were cases of primary hip arthroscopy between July 2014 and April 2017. Included patients had recorded pre-operative and 1-year post-operative modified Harris Hip Score (mHHS) and 12-item international Hip Outcome Tool (iHOT-12) scores.

Predictors of Clinical Outcomes After Hip Arthroscopy: 5-Year Follow-up Analysis of 1038 Patients.

Background: Although hip arthroscopy has been shown to have favorable results, there is a paucity of literature describing predictive factors of 5-year clinical outcomes.

Purpose: To identify predictive factors of midterm outcomes after hip arthroscopy in a cohort of 1038 patients whose outcomes at minimum 2-year follow-up were previously reported. In addition, to provide a comparison of short- and midterm predictive factors in outcome measures after hip arthroscopy.

Arthroscopic-Assisted Intraosseous Bioplasty of the Acetabulum.

Intraosseous bioplasty (IOBP), has been previously described for arthroscopic-assisted treatment of subchondral bone cysts in the proximal tibia associated with early stages of knee osteoarthritis (OA). This technique entails combining bone marrow aspirate concentrate or concentrated platelet-rich plasma with demineralized bone matrix as a bone substitute before injecting into a subchondral bone defect under fluoroscopic guidance. The principles of IOBP as a procedure that combines core decompression with biologic bone substitute augmentation can be extended to treat subchondral bone marrow lesions such as acetabular and femoral cysts in degenerative hip OA.

In search of labral restoration function with hip arthroscopy: outcomes of hip labral reconstruction versus labral repair: a systematic review.

Purpose: To perform a systematic review comparing patient-reported outcomes (PROs) in patients who underwent hip arthroscopy with labral repair versus labral reconstruction in the setting of femoroacetabular impingement syndrome (FAIS) and labral tears.

Methods: A systematic review of the PubMed, Embase, and Cochrane databases was performed in May 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and checklist. Articles were included in the analysis if they compared PROs between a labral repair and labral reconstruction cohort.

Optimal Treatment of Cam Morphology May Change the Natural History of Femoroacetabular Impingement.

Background: There is debate in the literature whether cam morphology is associated with increased risk for hip osteoarthritis. The capability of femoroplasty to alter the natural history of cam morphology is still in question.

Purpose: To (1) investigate the correlation between cam morphology and damage to the articular cartilage and (2) assess whether correction of the cam morphology affects survivorship of the joint, progression to arthroplasty, and functional patient-reported outcome scores.

Prevalence of Gluteus Medius Pathology on Magnetic Resonance Imaging in Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement: Asymptomatic Tears Are Rare, Whereas Tendinosis Is Common.

Background: There is a paucity of literature on asymptomatic gluteus medius pathology. Moreover, no studies have examined the prevalence of asymptomatic gluteus medius pathology.

Purpose: To describe the prevalence of asymptomatic gluteus medius pathology in patients undergoing hip arthroscopy for femoroacetabular impingement.

Outpatient vs. inpatient hip arthroplasty: a matched case-control study on a 90-day complication rate and 2-year patient-reported outcomes.

Background: The transition to outpatient-based surgery is a major development occurring in recent years in the field of total hip arthroplasty (THA). The effect of this transition on patient-reported outcomes (PROs) is still not well established. The purpose of the current study was to compare patients undergoing inpatient THA (iTHA) to patients undergoing outpatient THA (oTHA) regarding (1) perioperative variables including surgical time, blood loss, and length of stay (2) 90-day complication rates and unplanned emergency room or office visits (3) 2-year PROs including modified Harris hip score (mHHS), Harris hip score (HHS), forgotten joint score (FJS), pain, and satisfaction, as well as the quality of live measures.

The cost-effectiveness of outpatient surgery for primary total hip arthroplasty in the United States: a computer-based cost-utility study.

Purpose: The purpose of this study was to perform a cost-effectiveness analysis of outpatient versus inpatient total hip arthroplasty (THA) in the USA, considering complication probability and the potential cost of such complications.

Methods: A cost-effectiveness analysis was conducted from the societal perspective to evaluate the incremental cost and effectiveness of inpatient THA compared to outpatient THA over a lifetime horizon. Effectiveness was expressed in quality-adjusted life years (QALYs).

Asymptomatic Gluteal Tendinopathies Negatively Impact Outcomes of Total Hip Arthroplasty: A Propensity Score-Matched Study.

Background: The purpose of this study is to compare outcomes after total hip arthroplasty (THA) in patients with preoperative asymptomatic gluteus medius and minimus (GMM) pathology to a control group with no GMM pathology.

Methods: Patients undergoing THA for osteoarthritis between August 2012 and March 2018 were retrospectively reviewed. Asymptomatic GMM pathology was considered as the presence of gluteal tendinopathy diagnosed by magnetic resonance imaging (MRI) without the following clinical symptoms: Trendelenburg gait or test, abductor weakness, and lateral thigh tenderness.

An Iliopsoas Impingement Lesion in the Absence of Painful Internal Snapping May Not Require Iliopsoas Fractional Lengthening.

Background: Iliopsoas impingement (IPI) has been associated with a distinct lesion on the anterior labrum. Iliopsoas fractional lengthening (IFL) can treat IPI in instances of painful internal snapping (PIS) and mechanical groin pain.

Purpose: To report minimum 2-year outcomes of patients without PIS who had an IPI lesion diagnosed intraoperatively that did not undergo IFL (+IPI -PIS -IFL) as compared with a matched group of patients with PIS and an IPI lesion that was treated with IFL (+IPI +PIS +IFL).

Stepwise Safe Access in Hip Arthroscopy in the Supine Position: Tips and Pearls From A to Z.

Hip arthroscopy is rapidly growing as a treatment with good outcomes for pathologic conditions such as femoroacetabular impingement syndrome and labral tears. At the same time, it is one of the most technically challenging and demanding procedures in orthopaedics with a technically demanding skill. The first challenge is to safely access the joint, which requires accurate anatomical knowledge, a strong sense of spatial orientation, and repeated practice.

Mid-Term Outcomes of Endoscopic Gluteus Medius Repair With Concomitant Arthroscopic Labral Treatment: A Propensity-Matched Controlled Study.

Purpose: To report mid-term outcomes of patients who underwent endoscopic gluteus medius (GM) repair with arthroscopic labral treatment and to compare them with a control cohort of patients who underwent arthroscopic labral treatment without an endoscopic GM repair.

Methods: Data were prospectively collected and retrospectively reviewed for all patients who underwent primary hip arthroscopy between February 2008 and August 2013. Patients were included if they underwent arthroscopic labral treatment, endoscopic GM repair, and had preoperative with minimum 5-year follow-up for the following patient-reported outcomes: modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS).

Binary Tönnis classification: simplified modification demonstrates better inter- and intra-observer reliability as well as agreement in surgical management of hip pathology.

Background: The traditional Tönnis Classification System has inherent drawbacks as it is vulnerable to the subjectivity of a four-grade system. A two-grade classification could potentially be more reliable. The purpose of this study is to (1) compare the inter-observer and intra-observer reliability of the traditional Tönnis Classification System and a simplified Binary Tönnis Classification System for hip osteoarthritis and to (2) evaluate the clinical applicability of both systems.

Full-Thickness Gluteus Medius Tears With or Without Concomitant Hip Arthroscopy: Minimum 2-Year Outcomes Using an Open Approach and Contemporary Tendon Repair Techniques.

Background: Gluteus medius (GM) tears are a well-established source of pain and disability. An open approach has been recognized with complete full-thickness and large GM tears, yet the current literature provides few reports on outcomes for this specific situation.

Purpose: To report and analyze minimum 2-year patient-reported outcomes (PROs) from patients who underwent open GM repair in the setting of a full-thickness tear with or without concomitant hip arthroscopy through use of contemporary tendon repair techniques.

Robotic Arm-assisted Total Hip Arthroplasty is More Cost-Effective Than Manual Total Hip Arthroplasty: A Markov Model Analysis.

Background: Total hip arthroplasty (THA) is the benchmark surgical treatment of advanced and symptomatic hip osteoarthritis. Preliminary evidence suggests that the robotic arm-assisted (RAA) technology yields more accurate and reproducible acetabular cup placement, which may improve survival rate and clinical results, but economic considerations are less well-defined. The purpose of this study was to compare the cost effectiveness of the RAA THA with manual THA (mTHA) modalities, considering direct medical costs and utilities from a payer's perspective.

Robotics and Navigation as Learning Tools for Fellows Training in Hip Arthroplasty.

Introduction: The association between implant malpositioning and complications has been repeatedly demonstrated. Recently, technological advancements have allowed for more consistent implant placement. Beyond this obvious application, these technologies may also serve as a learning tool.

Surgeon Experience in Hip Arthroscopy Affects Surgical Time, Complication Rate, and Reoperation Rate: A Systematic Review on the Learning Curve.

Purpose: To systematically review the literature to (1) identify the reported learning curves associated with hip arthroscopy and (2) evaluate the effect of the stated learning curves on outcomes, such as complication rates, surgical and traction time, reoperation rates, and patient-reported outcome score (PRO) improvements.

Methods: Two independent reviewers screened the PubMed-MEDLINE, Embase, and Cochrane Library electronic databases from inception to January 2020 according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The following search algorithm was used: "hip arthroscopy" paired with "learning curve," "competence," "experience," "performance," and "motor skills.