Surgical Technique: Hip Arthroscopy for Hip Dysplasia

2021 ◽  
pp. 1-22
Author(s):  
Laura A. Vogel ◽  
Tigran Garabekyan ◽  
Omer Mei-Dan
Keyword(s):  
Surgical Technique ◽  
Hip Arthroscopy ◽  
Hip Dysplasia

scholarly journals One stage hip arthroscopy and periacetabular osteotomy: surgical technique and initial results

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0001
Author(s):  
Gerardo Zanotti ◽  
Fernando Comba ◽  
Eduardo Genovesi ◽  
Martin Buttaro ◽  
Francisco Piccaluga
Keyword(s):  
Surgical Technique ◽  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Combined Treatment ◽  
Radiographic Examination ◽  
Edge Angle ◽  
One Stage ◽  
Center Edge ◽  
Center Edge Angle

Aim: We purposed to describe the surgical technique and preliminary outcomes of combined arthroscopic and periacetabular osteotomy (PAO) for the treatment of non-arthritic hip dysplasia. Methods: Between May and August 2015, 4 patients (3 female, 1 male) with an average age of 29 years old (range; 22-33) had undergone one-stage hip arthroscopy and periacetabular osteotomy. Primary symptom was pain associated with instability. Upon radiographic examination, mean lateral center-edge angle of Wiberg was 12° (range; 7°-18°). Intra-articular findings were computed and primary outomes were as follows: radiographic angular correction; time to healing after pelvis osteotomy and functional results according to Merle D’Aubigné Score. Results: Minimum follow-up was 6 months whereas maximum was 9 months. Mean surgical time was 98 minutes for hip arthroscopy and 132 minutes for the osteotomy. In all cases, a lesion of the antero-superior labrum and the chondro-labral junction was found and repaired. After correction, overall postoperative center-edge angle was 29° (range; 25°-35°). Bone healing was certified in all cases at 6 months postoperatively. Overall Merle D’Aubigné Score was 17/18 points. Conclusion: Combined treatment of non-arthritic hip dysplasia with hip arthroscopy and PAO obtained good clinical and radiological outcomes. Former arthroscopy enables the diagnosis of cartilage lesions and intra-articular pathology as well as it aids in proceeding or not to an open correction.

Does Hip Arthroscopy Have a Role in the Treatment of Developmental Hip Dysplasia?

2017 ◽  
Vol 32 (9) ◽  
pp. S28-S31 ◽  
Author(s):  
Jacob M. Kirsch ◽  
Moin Khan ◽  
Asheesh Bedi
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Developmental Hip Dysplasia

scholarly journals Single Table Concomitant Post-Less Hip Arthroscopy Combined with Periacetabular Osteotomy for Hip Dysplasia

2019 ◽  
Vol 8 (12) ◽  
pp. e1569-e1578
Author(s):  
Dustin Woyski ◽  
Steve Olson ◽  
Brian Lewis
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy

scholarly journals The utility of hip arthroscopy for patients with painful borderline hip dysplasia

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092316
Author(s):  
Deuk-Soo Hwang ◽  
Chan Kang ◽  
Jeong-Kil Lee ◽  
Jae-Young Park ◽  
Long Zheng ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Reoperation Rate ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Control Group ◽  
The Mean ◽  
Tönnis Grade

Purpose: We measured the width of the acetabular labra in, and the clinical outcomes of, patients with borderline hip dysplasia (HD) who underwent arthroscopy. Methods: A total of 1436 patients who underwent hip arthroscopy to treat symptomatic, acetabular labral tears were enrolled. From this cohort, we extracted a borderline HD group (162 cases). Lateral labral widths were evaluated using preoperative magnetic resonance imaging scans. Clinical data including the modified Harris hip score (mHHS), non-arthritic hip score (NAHS), hip outcome score–activity of daily living (HOS-ADL) score, visual analog scale (VAS) pain score, and Tönnis grade were collected. In addition, patient satisfaction with arthroscopy outcomes was rated. All complications and reoperations were noted. Results: The mean follow-up time was 87.4 months. The lateral labral width was 7.64 mm in those with normal hips and 7.73 mm in borderline HD patients, respectively ( p = 0.870). The Tönnis grade progressed mildly from 0.46 to 0.76 ( p = 0.227). At the last follow-up, clinical outcome scores (mHHS, NAHS, and HOS-ADL scores) and the VAS score were improved ( p < 0.001). The mean patient satisfaction was scored at 8.2. The reoperation rate was higher in those who underwent labral debridement (25.6%) than labral repair (4.1%). Conclusions: The lateral labral width did not differ significantly between the borderline HD group and the nondysplastic control group. Arthroscopy relieved the symptoms of painful borderline HD and did not accelerate osteoarthritis. Therefore, if such patients do not respond to conservative treatment, hip arthroscopy can be considered for further treatment.

Functional and Clinical Outcomes of Patients Undergoing Revision Hip Arthroscopy With Borderline Hip Dysplasia at 2-Year Follow-up

2019 ◽  
Vol 35 (12) ◽  
pp. 3240-3247 ◽  
Author(s):  
Jourdan M. Cancienne ◽  
Edward C. Beck ◽  
Kyle N. Kunze ◽  
Jorge Chahla ◽  
Sunikom Suppauksorn ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Hip Arthroscopy ◽  
Hip Dysplasia

scholarly journals Neuromonitoring Changes During Hip Arthroscopy in the Pediatric Population

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0042
Author(s):  
Trevor J. Shelton ◽  
Akash R. Patel ◽  
Lauren Agatstein ◽  
Brian Haus
Keyword(s):  
Hip Arthroscopy ◽  
Peroneal Nerve ◽  
Pudendal Nerve ◽  
Hip Dysplasia ◽  
Pediatric Patients ◽  
Tibial Nerve ◽  
Pediatric Population ◽  
Labral Tear ◽  
Posterior Tibial Nerve ◽  
Posterior Tibial

Objectives: The objectives of this study were to determine the prevalence, pattern, and predisposing factors for sciatic, femoral, obturator, and pudendal nerve injury during hip arthroscopy in the pediatric population. Methods: We retrospectively reviewed charts of all pediatric patients who underwent hip arthroscopy with neuromonitoring from 2013 until May 2018. Neuromonitoring included when traction was applied and removed, and somatosensory evoked potentials (SSEP) in the peroneal and posterior tibial nerves and electromyography (EMG) signal for the obturator, femoral, and peroneal and posterior tibial branch of the sciatic nerves. Each report was reviewed for total traction time, EMG changes, SSEP changes more than 50% after traction application, and the time for SSEPs to return to baseline. Demographic data and postoperative notes were reviewed for any signs of clinical nerve injury and if/when recovery occurred. We determined the rate of SSEP and EMG changes, time from traction onset to SSEP and EMG changes, time after traction released until SSEP returns to baseline, and rate of neuropraxia and any potential risk factors. Results: We identified 78 patients who underwent hip arthroscopy (16±2 years of age; 54 females). Reasons for hip arthroscopy included femoral acetabular impingement (37%), hip dysplasia with labral tear (27%), slipped capital femoral epiphysis (23%), labral tear (5%), snapping hip (3%), diagnostic scope (3%), Perthes with labral tear (1%), and trauma (1%). Average traction time was 64±30 min. SSEPs decreases of less than 50% occurred in 76% of patients in the peroneal nerve, and 69% of patients in the posterior tibial nerve. In the contralateral limb, there was a 50% drop in SSEPs in the peroneal nerve in 13% of patients and in the posterior tibial nerve in 8% of patients. For the peroneal nerve, this drop in signal occurred 23±11 min after traction was applied and returned intraoperatively at a rate of 74% 29±23 min after traction removal. For the posterior tibial nerve, this drop in signal occurred 22±12 min after traction was applied and returned intraoperatively at a rate of 83% 24±15 min. after traction removal. EMG activity was observed after traction application in 10% of patients in the obturator nerve at 36±34 min., 9% of patients in the femoral nerve at 22 ± 15 min., 14% of patients in the peroneal nerve at 19±27 min, and 5% of patients in the posterior tibial nerve at 42±42 min. The rate of pudendal nerve neuropraxia was 0%. The rate of clinical neuropraxia postoperatively was 18%. Those who sustained a neuropraxia had on average a 54 min. longer surgery (p=0.005) and a trend towards a 14 min. longer traction time (p=0.096). Diagnosis had no statistical effect on the rate of clinical diagnosis. Conclusion: Hip arthroscopy is increasingly utilized to treat several unique diagnoses in the pediatric population. As such, it is important to understand the potential risks of treating different diagnosis in this population. The important findings of this study are that neuromonitoring changes occur in more than 70% of patients and 18% will have some decreased sensation in either their peroneal nerve or posterior tibial nerve that resolves within 1-2 days after surgery. There is also a low risk of neuropraxia if there are no neuromonitoring changes during surgery. Diagnosis (Hip dysplasia/SCFE/FAI) did not change incidence of neuropraxia. Longer surgery and traction time appear to be the only risk factors for neuropraxia in hip arthroscopy in pediatric patients.

scholarly journals Hip arthroscopy in the setting of hip dysplasia

2016 ◽  
Vol 5 (6) ◽  
pp. 225-231 ◽  
Author(s):  
M. Yeung ◽  
M. Kowalczuk ◽  
N. Simunovic ◽  
O. R. Ayeni
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia

scholarly journals Technique for Combined Hip Arthroscopy and Periacetabular Osteotomy for the Patient with Hip Dysplasia and Intraarticular Pathology

2016 ◽  
Vol 6 (1) ◽  
pp. 41-46
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Developmental Dysplasia ◽  
Acetabular Coverage ◽  
Powerful Technique ◽  
Ongoing Pain ◽  
Dysplasia Of The Hip

ABSTRACT The Bernese periacetabular osteotomy (PAO) is a powerful technique for correcting acetabular coverage in patients with developmental dysplasia of the hip. However, there is increasing recognition of additional intraarticular pathologies that may contribute to ongoing pain. For this reason, for the last 3 years, we have combined hip arthroscopy with PAO to treat intraarticular pathology along with improving acetabular coverage. Our technique is reviewed below. Lewis BD, Olson SA. Technique for Combined Hip Arthroscopy and Periacetabular Osteotomy for the Patient with Hip Dysplasia and Intraarticular Pathology. The Duke Orthop J 2016;6(1):41-46.

Periacetabular osteotomy and arthroscopic labral repair after failed hip arthroscopy due to iatrogenic aggravation of hip dysplasia

2013 ◽  
Vol 22 (4) ◽  
pp. 911-914 ◽  
Author(s):  
Timothy J. Jackson ◽  
Jonathan Watson ◽  
Justin M. LaReau ◽  
Benjamin G. Domb
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Labral Repair

scholarly journals Traffic-Light Grading System of Hip Dysplasia to Predict Success Following Hip Arthroscopy

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Owain Lloyd Ioan Davies ◽  
George Grammatopoulos ◽  
Thomas C.B. Pollard ◽  
Antonio (Tony) Andrade
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Grading System ◽  
Traffic Light
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