Endoscopic Technique: Sciatic Neurolysis and Piriformis Tendon Release for Treating Piriformis Syndrome.

Piriformis syndrome (PS) is an underdiagnosed condition, caused by entrapment of the sciatic nerve by the piriformis muscle tendon and adhesions in the deep gluteal space. We present a step-by-step endoscopic technique with the patient in a prone position through a posterior approach. This approach provides improved orientation for tracking the sciatic nerve from distal to proximal, facilitating the release of all adhesions and concluding with a piriformis tendon release.

Clinically Relevant Thresholds for Hip Arthroscopy Vary: A Systematic Review.

Purpose: To identify the PASS and SCB thresholds for hip arthroscopy and provide guidance on how to choose among the thresholds.

Methods: A systematic review of literature was conducted in PubMed and MEDLINE databases in August 2024 using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies with Level I to IV evidence that defined SCB or PASS thresholds for PROs for hip arthroscopy in the setting of intra-articular pathology were included.

With Proper Surgical Indications, Sex-Based Differences in Pathology Do Not Impact Hip Arthroscopy Outcomes or Complications: A Systematic Review.

Purpose: To identify sex-based differences in pathology, outcomes, and complications after hip arthroscopy for femoroacetabular impingement (FAI), and to compare patient-reported outcomes (PRO) scores between males and females.

Methods: The PubMed and MEDLINE databases were searched in September 2024, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies had data stratified by sex, minimum 2-year patient reported outcome (PRO) scores for hip arthroscopy in the setting of FAI and labral pathology, and a 2014 or later publication date.

Perioperative testosterone supplementation improves outcomes of orthopedic surgeries: A Systematic review of heterogeneous studies.

Purpose: The purpose of this study is to assess the effect of perioperative testosterone supplementation on orthopedic surgical outcomes.

Methods: Three online databases were searched from database inception until September 2024. Three reviewers independently screened all titles, abstracts, and full-texts of articles investigating perioperative testosterone use in orthopedic surgery.

Patient-Reported Outcomes After Periacetabular Osteotomy Versus Hip Arthroscopy for Borderline Acetabular Dysplasia Are Both Favorable: A Systematic Review.

Purpose: To compare patient populations and outcomes in studies treating borderline hip dysplasia (BHD) with either hip arthroscopy or periacetabular osteotomy (PAO).

Methods: We conducted a literature review according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies published after 2014 that reported patient-reported outcome measures (PROMs) after hip arthroscopy or PAO for BHD. Preoperative demographic characteristics, radiographic variables, operative findings, procedures, postoperative outcomes, and complications were recorded.

Arthroscopic anterior cruciate ligament reconstruction with and without tourniquet use: an updated systematic review and meta-analysis on clinical outcomes.

Background: The use of a tourniquet is common during anterior cruciate ligament (ACL) reconstruction, offering convenience for the surgical procedure. However, the potential adverse effects of tourniquet use have gained increasing attention from clinical researchers. We conducted this systematic review and meta-analysis to compare the clinical outcomes of tourniquet application versus non-tourniquet approach during arthroscopic ACL reconstruction.

Endoscopic Iliopsoas Fractional Lengthening as a Treatment for Refractory Iliopsoas Impingement After Total Hip Arthroplasty Shows Favorable Functional Outcomes With No Impact on Range of Motion.

Purpose: To report the minimum 2-year clinical outcomes of endoscopic iliopsoas fractional lengthening (IFL) in patients with recalcitrant iliopsoas tendinitis after total hip arthroplasty (THA).

Methods: Data were prospectively collected from 2014 to 2020 for patients who underwent IFL after primary THA as part of our institutional hip outcomes registry. Patients were included if they had completed the following patient-reported outcomes preoperatively and at minimum 2-year follow-up: modified Harris Hip Score and visual analog scale score.

Radiographs Underestimate Lateral Center-Edge Angle and Tönnis Angle Measurements Compared to Computed Tomography Scan in Assessment of Borderline and Frank Acetabular Dysplasia.

Purpose: To compare lateral center-edge angle (LCEA) and Tönnis angle (TA) values measured in radiographs and computed tomography (CT) scans with commercially available software and to determine the degree of concurrence in the classification of acetabular dysplasia as depicted in radiographs and CT scans.

Methods: Retrospectively collected data from patients undergoing preoperative CT protocol and x-rays for hip arthroscopy from June 2019 to December 2021. The preoperative anteroposterior supine view of the pelvis was utilized to measure LCEA and TA, and measurements were compared to CT scan views through commercially available software.

Predicting Outstanding Results Following Primary Total Hip Arthroplasty Using the Maximal Outcome Improvement Threshold.

Background: The delta difference between baseline patient-reported outcome measure scores and postoperative scores is used to measure success following primary total hip arthroplasty (THA). However, statistical improvement is not necessarily equal to clinical benefit. The percentage of the maximal outcome improvement (MOI) is a psychometric tool to determine clinical improvement.

Circumferential Labral Reconstruction With Knotless All-Suture Anchors Restores Hip Distractive Stability: A Cadaveric Biomechanical Analysis.

Background: The essential component of managing femoroacetabular impingement involves restoration of the original labral function. Circumferential labral reconstruction (CLR) has shown positive results. However, biomechanical studies of CLR are limited and have not established the efficacy of the modern knotless all-suture anchor (ASA) pull-through technique.

The Impact of Previous Lumbar Spine Surgery on Primary Total Hip Arthroplasty: Minimum 2-Year Outcomes Controlling for Approach and Technology.

Background: Prior lumbar spine surgery (LSS) can limit spine mobility, potentially increasing hip motion requirements. This study aimed to assess the influence of LSS on primary total hip arthroplasty (THA).

Methods: Retrospective analysis was conducted on patients who underwent THA with prior LSS.

Ten-Year Outcomes in Patients Aged 40 Years and Older After Primary Arthroscopic Treatment of Femoroacetabular Impingement With Labral Repair.

Background: Arthroscopic labral repair has been shown to result in favorable short- and midterm outcomes; however, the durability of outcomes specifically in older patients remains underreported.

Purpose: To (1) report prospectively collected hip preservation rates and patient-reported outcome measures (PROMs) at a minimum 10-year follow-up in patients aged ≥40 years after primary hip arthroscopy with labral repair and (2) perform a matched analysis comparing patients aged ≥40 years with patients aged <40 years.

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

Comparative Study of Alternative Methods for Measuring Leg Length Discrepancy after Robot-Assisted Total Hip Arthroplasty.

Background: Our study addresses the lack of consensus on measuring leg length discrepancy (LLD) after total hip arthroplasty (THA). We will assess the inter-observer variability and correlation between the five most commonly used LLD methods and investigate the use of trigonometric principles in overcoming the limitations of current techniques.

Methods: LLD was measured on postoperative AP pelvic radiographs using five conventional methods.

Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States.

Background: The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular impingement.

Aim: To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric hips. We hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both sexes.

Best practices on patient education materials in hip surgery based on learnings from major hip centers and societies.

Patient education is important as it gives patients a better understanding of the risks and benefits of medical and surgical interventions. Developing communication technologies have completely changed and enhanced patient access to medical information. The aim of this study was to evaluate available patient education materials (PEMs) regarding hip surgery on the websites of major hip societies and centers.

Editorial Commentary: Socioeconomic Disparities in Health Outcomes: The Patient Behind the Procedure.

Equitable delivery of health care, regardless of sex, race, ethnicity, or socioeconomic status, is shown to be generally unsuccessful. The benefits of standardized treatment protocols to increase clinical consistency and efficiency are clear-but risk inferior outcomes if not adapted to account for socioeconomically disadvantaged patients. Underinsured patients face challenges accessing continuous and comprehensive care, even during the postoperative period.

A multicentre prospective assessment of the utility of robotic assisted total hip arthroplasty with virtual range of motion on intraoperative implant positioning.

Background: The growing adoption of robotic-assistance during total hip arthroplasty (THA) has provided novel means through which a patient's anatomy and dynamic spinopelvic relationship can be incorporated into surgical planning. However, the impact of enhanced technologies on intraoperative decision-making and changes to component positioning has not yet been described.

Methods: A multicentre, prospective study included 105 patients (52% women) patients who underwent robotic-assisted THA with the integration of software that incorporates a patient's pelvic tilt (PT) and virtual range-of-motion (VROM) for impingement modeling.

Predictors of Clinical Outcomes After Hip Arthroscopy: 10-Year Follow-up Analysis of 1038 Patients.

Background: Although hip arthroscopy has been shown to have beneficial outcomes, there is a paucity of literature examining predictive factors of 10-year clinical outcomes.

Purpose: (1) To identify predictive factors of 10-year outcomes of hip arthroscopy and (2) to compare these factors with those found in 2-year and 5-year studies.

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

Parachute Technique for Dermal Allograft Augmentation in Open Gluteal Abductor Repair.

Retracted full-thickness tears of the gluteus medius tendon are a well-recognized cause of disabling weakness and pain that significantly impact patients' quality of life. We present an efficient knotless parachute technique for dermal allograft augmentation in open gluteal abductor tendon repairs. Our technique reinforces the suture-tendon interface by incorporating a robust biological scaffold into a knotless double-row fixation.

Long-term Survivorship and Outcomes of Patients Without Dysplasia Undergoing Capsular Repair During Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Background: There is a paucity of literature evaluating long-term outcomes and survivorship of patients undergoing primary hip arthroscopy with capsular repair for femoroacetabular impingement syndrome (FAIS).

Purpose: To report 10-year survivorship and patient-reported outcomes (PROs) after primary hip arthroscopy with capsular repair for FAIS and evaluate the effect of capsular repair in patients at the highest risk for conversion to arthroplasty.

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

Variations in the Anatomic Morphology of the Scapular Spine and Implications on Fracture After Reverse Shoulder Arthroplasty.

Introduction: This study evaluates the role of anatomic scapular morphology in acromion and scapular spine fracture (SSAF) risk after reverse shoulder arthroplasty (RSA).

Methods: Twelve scapular measurements were captured based on pilot study data, including scapular width measurements at the acromion (Z1), middle of the scapular spine (Z2), and medial to the first major angulation (Z3). Measurements were applied to 3D-CT scans from patients who sustained SSAF after RSA (SSAF group) and compared with those who did not (control group).

Knotless Tensionable Anchors: Versatility, Tips, and Tricks.

Arthroscopic surgery, including implants and advanced techniques, continues to advance in the field of orthopaedics. The evolution of suture anchors has undergone design changes, passing from first-generation metal anchors, biodegradable materials, different plastic polymers, to all-suture constructs. Knotless technology also has been found to be a more reproducible method and have comparable outcomes with those found using knotted anchors.