Beyond the Basics of Athletic Hip Evaluation.

Abstract: There is a growing trend in the world of orthopedics and sports medicine revolving around the nonarthritic hip. The incidence of hip arthroscopy has exponentially grown in the past decade and despite the importance of the recognition of these hip pathologies as contributors to pain and dysfunction, there is an ever-increasing rate of "failed" procedures emerging in the literature. The etiology of femoroacetabular impingement (FAI) syndrome and associated pathologies of the hip are now better understood.

Influence of Tönnis Grade on Outcomes of Arthroscopic Management of Symptomatic Femoroacetabular Impingement.

Purpose: To define the outcomes of arthroscopic correction of femoroacetabular impingement (FAI) based on Tönnis findings within a previously reported patient population, including a comparative analysis of Tönnis grade 0 and 1 versus grade 2 changes.

Methods: Outcomes (modified Harris Hip Score [mHHS]) of a previously published study of arthroscopic correction of FAI were correlated with Tönnis grade. The inclusion criteria were the first 100 consecutive patients undergoing arthroscopic FAI correction with minimum 2-year follow-up.

Radiographic Diagnosis of Pincer-Type Femoroacetabular Impingement: A Systematic Review.

Background: Femoroacetabular impingement (FAI) is a well-recognized condition that causes hip pain and can lead to early osteoarthritis if not managed properly. With the increasing awareness and efficacy of operative treatments for pincer-type FAI, there is a need for consensus on the standardized radiographic diagnosis.

Purpose: To perform a systematic review of the evidence regarding imaging modalities and radiographic signs for diagnosing pincer-type FAI.

Evaluation and management of the snapping iliopsoas tendon.

Snapping caused by the iliopsoas tendon ("internal coxa saltans") is a common incidental observation that often requires little treatment on the part of the clinician other than assurance to the patient that this finding is not a harbinger of future problems. Most symptomatic patients can be managed with a properly structured conservative treatment program. However, surgical intervention may be indicated for select recalcitrant painful snapping that is unresponsive to conservative treatment.

Hip arthroscopy by the supine approach.

The supine approach to arthroscopy of the hip has been well described, and the safe zones for arthroscopy and the technique of precise portal placement necessary for optimal access have been well established. However, with a growing understanding of hip pathology and its etiology, additional methods have been devised to address this pathology. Thus, the technique of hip arthroscopy continues to evolve, including incorporation of the peripheral compartment evaluation as part of the routine procedure.

Hip arthroscopy: the supine position.

Hip arthroscopy performed with the patient in the supine position is an effective, reproducible procedure. Advantages include ease and simplicity of patient positioning, use of a standard fracture table, operating room layout that is user friendly, familiar joint orientation, and optimal access for all portal placements. All technical aspects of performing the procedure are detailed, including necessary equipment, patient positioning, landmarks, portal placement, and arthroscopic anatomy.

Hip arthroscopy: patient assessment and indications.

Hip arthroscopy is often performed for disorders that in the past have gone unrecognized and untreated. The arthroscope has helped in the understanding of the nature of numerous intra-articular lesions, subsequently leading to improved assessment skills for these often elusive disorders, including interpretation of the history, examination findings, and technical advances in imaging studies. The indications for this procedure have been well defined but continue to evolve.

Hip arthroscopy in athletes.

The hip has received relatively little attention as a recognized site of sports injuries. However, arthroscopy has been used to identify numerous treatable sources of intra-articular pathology with good results. Historically, athletes with hip injuries were simply resigned to living within the constraints of their symptoms, being diagnosed with an ill-defined chronic groin injury and often prematurely ending their competitive careers.