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.

Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up.

Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting patient reported outcomes (PROs) and return to sport (RTS) in competitive or recreational tennis players after arthroscopic hip surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and RTS in tennis players who underwent arthroscopic hip surgery and (2) compare outcomes between recreational and competitive tennis players.

The Femoral Head "Divot" Sign: A Useful Arthroscopic Sign of Hip Microinstability.

Background: A femoral head "divot" is a rare finding during hip arthroscopy. A linear chondral indentation can be observed on the femoral head, just lateral and parallel to the acetabular labrum.

Purpose/hypothesis: The purpose of this study was to describe a novel arthroscopic sign and retrospectively review patients with this finding.

Minimum 5-Year Outcomes of Robotic-assisted Primary Total Hip Arthroplasty With a Nested Comparison Against Manual Primary Total Hip Arthroplasty: A Propensity Score-Matched Study.

Background: Robotic-assisted technology has been a reliable tool in enhancing precision and accuracy of cup placement in total hip arthroplasty (THA). Still, questions remain on the clinical benefit of this technology.

Methods: The purposes of the ongoing study were (1) to report on minimum 5-year outcomes in patients who underwent robotic-assisted primary THA (rTHA), (2) to compare those outcomes to a propensity score-matched manual primary THA (mTHA) control group, and (3) to compare radiographic measures between the groups regarding acetabular cup placement.

Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip.

Background: Labral reconstruction has been advocated as an alternative to debridement for the treatment of irreparable labral tears, showing favorable short-term results. However, literature is scarce regarding outcomes and return to sport in the nonelite athletic population.

Purpose: To report minimum 1-year clinical outcomes and the rate of return to sport in athletic patients who underwent primary hip arthroscopy with labral reconstruction in the setting of femoroacetabular impingement syndrome and irreparable labral tears.

Direct Anterior Approach in Total Hip Arthroplasty Leads to Superior Outcomes at 3-Month Follow-up When Compared With the Posterior Approach: A Matched Study Using Propensity Score Analysis.

Unlabelled: The purpose of this study was to report and compare early outcomes during the first 3 months of the recovery phase in patients who underwent primary total hip arthroplasty (THA) with direct anterior approach (DAA) and posterior approach (PA).

Background: The DAA for primary THA has gained popularity within the past few years. Although controversy exists regarding the long-term benefit when compared with the PA, several authors have reported markedly better outcomes in the early recovery weeks, when using DAA.

Selective Component Retainment in the Treatment of Chronic Periprosthetic Infection After Total Hip Arthroplasty: A Systematic Review.

Introduction: Chronic infections after a total hip arthroplasty (THA) are a devastating complication and are usually treated by a complete revision of components. Selective revision, with preservation of well-fixed components, has been previously reported. We did a systematic review to report on success rates of selective revision in chronic infections after THA.

Instantaneous depolarization of T cells via dopamine receptors, and inhibition of activated T cells of Psoriasis patients and inflamed human skin, by D1-like receptor agonist: Fenoldopam.

Activated T cells are pathological in various autoimmune and inflammatory diseases including Psoriasis, and also in graft rejection and graft-versus-host-disease. In these pathological conditions, selective silencing of activated T cells through physiological receptors they express remains a clinical challenge. In our previous studies we found that activation of dopamine receptors (DRs) in resting human T cells activates these cells, and induces by itself many beneficial T cell functions.

Perineal Pressure During Hip Arthroscopy Is Reduced by Use of Trendelenburg: A Prospective Study With Randomized Order of Positioning.

Background: The use of traction during hip arthroscopy is commonly used to provide safe joint access and to improve visualization. However, traction during hip arthroscopy has been associated with complications ranging from transient neuropraxias to devastating soft-tissue necrosis. Trendelenburg positioning may be helpful, but the degree to which this is true is not well understood.

Intensive Glucose Control in Patients with Type 2 Diabetes - 15-Year Follow-up.

Background: We previously reported that a median of 5.6 years of intensive as compared with standard glucose lowering in 1791 military veterans with type 2 diabetes resulted in a risk of major cardiovascular events that was significantly lower (by 17%) after a total of 10 years of combined intervention and observational follow-up. We now report the full 15-year follow-up.

Sideline Management of Nonmusculoskeletal Injuries by the Orthopaedic Team Physician.

Although recognized as the most well-trained providers to address musculoskeletal injuries, many orthopaedic surgeons do not routinely treat patients with nonmusculoskeletal issues in their clinical practice. Nonetheless, when serving as a team physician, an orthopaedic surgeon may need to initiate management of or manage many nonmusculoskeletal issues. Knowing how to accurately diagnose and initiate management of sports-related medical and surgical conditions is an important facet of being an orthopaedic team physician.

Hip Arthroscopy for Femoroacetabular Impingement and Labral Tears in Patients Younger than 50 Years: Minimum Five-year Outcomes, Survivorship, and Risk Factors for Reoperations.

Introduction: There is a paucity of literature on mid-term outcomes for hip arthroscopy for femoroacetabular impingement and labral tears.

Methods: Inclusion criteria were age at surgery <50 years and documented preoperative patient-reported outcomes. Patients with a Tönnis grade >0 or previous ipsilateral hip conditions were excluded.

Acetabular Labral Debridement/Segmental Resection Versus Reconstruction in the Comprehensive Treatment of Symptomatic Femoroacetabular Impingement: A Systematic Review.

Purpose: To perform a systematic review comparing outcomes of labral debridement/segmental resection with labral reconstruction as part of a comprehensive treatment strategy for femoroacetabular impingement.

Methods: A systematic review was conducted according to established PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines using defined inclusion and exclusion criteria. The study groups were divided into labral debridement/segmental resection (group 1) and labral reconstruction (group 2).

Greater Trochanteric Pain Syndrome.

Patients who have lateral hip pain historically have been diagnosed with trochanteric bursitis and treated with nonsteroidal anti-inflammatory medications, corticosteroid injections, and physical therapy. Although this strategy is effective for most patients, a substantial number of patients continue to have pain and functional limitations. Over the past decade, our understanding of disorders occurring in the peritrochanteric space has increased dramatically.

Leg-Length Discrepancy After Total Hip Arthroplasty: Comparison of Robot-Assisted Posterior, Fluoroscopy-Guided Anterior, and Conventional Posterior Approaches.

Total hip arthroplasty (THA) effectively provides adequate pain relief and good long-term outcomes in patients with hip osteoarthritis. However, leg-length discrepancy (LLD) remains the most common cause of patient dissatisfaction and malpractice litigation in hip arthroplasty. We conducted a study to compare LLD in patients who underwent THA performed with a robot-assisted posterior approach (RTHA), a fluoroscopy-guided anterior approach (ATHA), or a conventional posterior approach (PTHA).

Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes.

Background: The Veterans Affairs Diabetes Trial previously showed that intensive glucose lowering, as compared with standard therapy, did not significantly reduce the rate of major cardiovascular events among 1791 military veterans (median follow-up, 5.6 years). We report the extended follow-up of the study participants.

Surgical technique: Endoscopic gluteus maximus tendon release for external snapping hip syndrome.

Background: While many authors have recommended surgery for patients with persistent symptoms of external snapping hip, it is unclear which one best relieves symptoms. Concerns with iliotibial band (ITB)-modifying techniques include altering the shape of the lateral thigh and overload of the contralateral abduction mechanism. We describe a new endoscopic technique that decreases the tension of the ITB complex by releasing the femoral insertion of the gluteus maximus tendon (GMT).