Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: Advanced Hip Arthroscopy 11 articles


Labral Injuries of the Hip in Rowers

Robert E. Boykin MD, Eric D. McFeely BA, Kathryn E. Ackerman MD, MPH, Yi-Meng Yen MD, PhD, Adam Nasreddine MA, Mininder S. Kocher MD, MPH

Injuries of the hip in the adolescent and young adult athlete are receiving more attention with advances in the understanding of femoroacetabular impingement (FAI), labral pathology, and hip arthroscopy. Labral tears have not been well characterized in rowers.

Why Do Hip Arthroscopy Procedures Fail?

Ljiljana Bogunovic MD, Meghan Gottlieb MSW, Gail Pashos BS, Geneva Baca BA, John C. Clohisy MD

Despite the successes of hip arthroscopy, clinical failures do occur, and identifying risk factors for failure may facilitate refinement of surgical indications and treatment. Knowledge regarding the reasons for treatment failures may also improve surgical decision making.

Surgical Approaches for Cam Femoroacetabular Impingement: The Use of Multicriteria Decision Analysis

Claudio Diaz-Ledezma MD, Javad Parvizi MD

Currently, three surgical approaches are available for the treatment of cam femoroacetabular impingement (FAI), namely surgical hip dislocation (SHD), hip arthroscopy (HA), and the miniopen anterior approach of the hip (MO). Although previous systematic reviews have compared these different approaches, an overall assessment of their performance is not available.

Spontaneous Hip Labrum Regrowth After Initial Surgical Débridement

Geoffrey D. Abrams, Marc R. Safran MD, Hassan Sadri MD

Anecdotal evidence from second-look hip arthroscopies and animal studies has suggested spontaneous labral regrowth may occur after débridement. However, these observations have not been systematically confirmed.

Anterior Inferior Iliac Spine Morphology Correlates With Hip Range of Motion: A Classification System and Dynamic Model

Iftach Hetsroni MD, Lazaros Poultsides MD, Asheesh Bedi MD, Christopher M. Larson MD, Bryan T. Kelly MD

The anterior inferior iliac spine (AIIS) contributes to hip dysfunction in patients with symptomatic impingement and resection of a prominent AIIS can reportedly improve function. However, the variability of the AIIS morphology and whether that variability correlates with risk of associated symptomatic impingement are unclear.

Novel CT-based Three-dimensional Software Improves the Characterization of Cam Morphology

Michael T. Milone BA, Asheesh Bedi MD, Lazaros Poultsides MD, PhD, Erin Magennis BA, J. W. Thomas Byrd MD, Christopher M. Larson MD, Bryan T. Kelly MD

Incomplete correction of femoral offset and sphericity remains the leading cause for revision surgery for symptomatic femoroacetabular impingement (FAI). Because arthroscopic exploration is technically difficult, a detailed preoperative understanding of morphology is of paramount importance for preoperative decision-making.

Do Professional Athletes Perform Better Than Recreational Athletes After Arthroscopy for Femoroacetabular Impingement?

Ajay Malviya FRCS (Tr & Orth), Christos P. Paliobeis MD, Richard N. Villar BSc, MA, MS

Although a large number of athletes’ returns to sports after hip arthroscopic surgery for femoroacetabular impingement (FAI), it is not clear if they do so to the preinjury level and whether professional athletes (PA) are more likely to return to the preinjury level compared with recreational athletes (RA).

Joint Space Predicts THA After Hip Arthroscopy in Patients 50 Years and Older

Marc J. Philippon MD, Karen K. Briggs MPH, John C. Carlisle MD, Diana C. Patterson BA

All patients considering joint-preserving hip arthroscopy should be educated on the risk of THA after arthroscopy. The degree of radiographic osteoarthritis predicts subsequent THA. To provide patients with the best information, the best radiographic measure that predicts THA after hip arthroscopy should be identified.

The Crossover Sign Overestimates Acetabular Retroversion

Ira Zaltz MD, Bryan T. Kelly MD, Iftach Hetsroni MD, Asheesh Bedi MD

The crossover sign is a radiographic finding associated with cranial acetabular retroversion and has been associated with pincer-type femoroacetabular impingement (FAI) in patients with hip pain. Variable morphology, location, and size of the anterior inferior iliac spine (AIIS) may contribute to the crossover sign even in the absence of retroversion. Thus, the sign may overestimate the incidence of acetabular retroversion.

Surgical Technique: Endoscopic Gluteus Maximus Tendon Release for External Snapping Hip Syndrome

Giancarlo C. Polesello MD, PhD, Marcelo C. Queiroz MD, Benjamin G. Domb MD, Nelson K. Ono MD, PhD, Emerson K. Honda MD, PhD

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).