Hip Arthroscopy: Difference between revisions
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===== Femoroacetabular impingement (FAI). ===== | ===== Femoroacetabular impingement (FAI). ===== | ||
[[Femoroacetabular Impingement|FAI]] is a common cause of [[Hip Pain & Mobility Deficits|hip pain]] in young people, and is caused by the of abnormal contact between [[Acetabulum Fracture|acetabular]] rim and proximal [[femur]] during movement<ref>Jamil M, Dandachli W, Noordin S, Witt J. Hip arthroscopy: [https://pubmed.ncbi.nlm.nih.gov/28823795/ Indications, outcomes and complications]. Int J Surg. 2018 Jun;54(Pt B):341-344. </ref>. Arthroscopic surgeries have been found to have statistically similar outcomes when compared to traditional open surgeries<ref>de Sa D, Lian J, Sheean AJ, Inman K, Drain N, Ayeni O, Mauro C. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154262/ A Systematic Summary of Systematic Reviews on the Topic of Hip Arthroscopic Surgery.] Orthop J Sports Med. 2018 Sep 21;6(9):2325967118796222. </ref>. A 2019 meta analysis and systematic review of 31 studies including a total of 1981 hips among 1911 patients for hip arthroscopy for FAI showed high percentage of patients return to [[Sport Injury Epidemiology|sport]] activities (87.7%) and significant improvement in all patient-reported outcome measures, except for mental health, with a low rate of complications (1.7%) and re-operation (5.5%)<ref>Minkara AA, Westermann RW, Rosneck J, Lynch TS. [https://pubmed.ncbi.nlm.nih.gov/29373805/ Systematic Review and Meta-analysis of Outcomes After Hip Arthroscopy in Femoroacetabular Impingement.] Am J Sports Med. 2019 Feb;47(2):488-500. </ref>. < | [[Femoroacetabular Impingement|FAI]] is a common cause of [[Hip Pain & Mobility Deficits|hip pain]] in young people, and is caused by the of abnormal contact between [[Acetabulum Fracture|acetabular]] rim and proximal [[femur]] during movement<ref name=":0">Jamil M, Dandachli W, Noordin S, Witt J. Hip arthroscopy: [https://pubmed.ncbi.nlm.nih.gov/28823795/ Indications, outcomes and complications]. Int J Surg. 2018 Jun;54(Pt B):341-344. </ref>. | ||
Arthroscopic surgeries have been found to have statistically similar outcomes when compared to traditional open surgeries<ref name=":1">de Sa D, Lian J, Sheean AJ, Inman K, Drain N, Ayeni O, Mauro C. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154262/ A Systematic Summary of Systematic Reviews on the Topic of Hip Arthroscopic Surgery.] Orthop J Sports Med. 2018 Sep 21;6(9):2325967118796222. </ref>. A 2019 meta analysis and systematic review of 31 studies including a total of 1981 hips among 1911 patients for hip arthroscopy for FAI showed high percentage of patients return to [[Sport Injury Epidemiology|sport]] activities (87.7%) and significant improvement in all patient-reported outcome measures, except for mental health, with a low rate of complications (1.7%) and re-operation (5.5%)<ref>Minkara AA, Westermann RW, Rosneck J, Lynch TS. [https://pubmed.ncbi.nlm.nih.gov/29373805/ Systematic Review and Meta-analysis of Outcomes After Hip Arthroscopy in Femoroacetabular Impingement.] Am J Sports Med. 2019 Feb;47(2):488-500. </ref>. A multi-center, assessor-blinded randomized controlled trial of 348 patients found hip arthroscopy and personalized physiotherapy both improved hip-related quality of life for patients with FAI. Hip arthroscopy led to a clinically significant greater improvement than personalized physiotherapy (p=0·0093)<ref>Griffin DR, Dickenson EJ, Wall PDH, Achana F, Donovan JL, Griffin J, Hobson R, Hutchinson CE, Jepson M, Parsons NR, Petrou S, Realpe A, Smith J, Foster NE; [https://pubmed.ncbi.nlm.nih.gov/29893223/ FASHIoN Study Group. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN):] a multicentre randomised controlled trial. Lancet. 2018 Jun 2;391(10136):2225-2235. </ref>. | |||
===== Labral tears ===== | |||
Arthroscopy can be used to find and diagnose labral teats, as well as for repair, debridement, or segmental resection procedures<ref name=":2">Cross GWV, Sobti AS, Khan T. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497996/ Hip arthroscopy in osteoarthritis: Is it an option?] J Clin Orthop Trauma. 2021 Sep 30;22:101617 </ref>. | |||
===== Greater trochanteric pain syndrome ===== | |||
For [[Greater Trochanteric Pain Syndrome|greater trochanteric pain syndrome]], arthroscopic [[Bursitis|bursectomy]], decompression or [[Iliotibial Band Syndrome|Iliotibial band]] release have had successful outcomes<ref name=":0" />. | |||
===== Snapping hip syndrome ===== | |||
For external [[Snapping Hip Syndrome|snapping hip syndrome]] the [[Iliotibial Tract|iliotibial]] band can be released, allowing the greater trochanter to move freely without snapping. For internal snapping hip syndrome, the [[Iliopsoas]] tendon snapping over can be released, to prevent snapping on the iliopectineal eminence or the [[Femoral Fractures|femoral]] head<ref name=":0" />. | |||
===== Paediatrics ===== | |||
* [[Hip Dysplasia|Hip dysplasia]] - to assess the chondral damage, which is a key prognostic indicator to decide further surgery. Surgical treatment outcomes are favorable, but with a reoperation rate of 14.1% to 67%.<ref name=":1" /> | |||
* [[Septic (Infectious) Arthritis|Septic arthritis]]<ref name=":0" /> | |||
* [[Slipped Capital Femoral Epiphysis|Slipped capital femoral epiphysis]]<ref name=":0" /> | |||
* [[Legg-Calve-Perthes Disease|Legg-Calvé-Perthes disease]]<ref name=":0" /> | |||
* [[Juvenile Idiopathic Arthritis|Juvenile Chronic Arthritis]]<ref name=":2" /> | |||
* Impingement in young athletes<ref name=":2" /> | |||
== Clinical Presentation == | == Clinical Presentation == | ||
Revision as of 16:45, 18 January 2023
Original Editor - User Name
Top Contributors - Chloe Waller and Kirenga Bamurange Liliane
Description
[edit | edit source]
Hip arthroscopy refers to minimally invasive surgery to assess or treat hip pathologies[1].
Indications[edit | edit source]
Femoroacetabular impingement (FAI).[edit | edit source]
FAI is a common cause of hip pain in young people, and is caused by the of abnormal contact between acetabular rim and proximal femur during movement[2].
Arthroscopic surgeries have been found to have statistically similar outcomes when compared to traditional open surgeries[3]. A 2019 meta analysis and systematic review of 31 studies including a total of 1981 hips among 1911 patients for hip arthroscopy for FAI showed high percentage of patients return to sport activities (87.7%) and significant improvement in all patient-reported outcome measures, except for mental health, with a low rate of complications (1.7%) and re-operation (5.5%)[4]. A multi-center, assessor-blinded randomized controlled trial of 348 patients found hip arthroscopy and personalized physiotherapy both improved hip-related quality of life for patients with FAI. Hip arthroscopy led to a clinically significant greater improvement than personalized physiotherapy (p=0·0093)[5].
Labral tears[edit | edit source]
Arthroscopy can be used to find and diagnose labral teats, as well as for repair, debridement, or segmental resection procedures[6].
Greater trochanteric pain syndrome[edit | edit source]
For greater trochanteric pain syndrome, arthroscopic bursectomy, decompression or Iliotibial band release have had successful outcomes[2].
Snapping hip syndrome[edit | edit source]
For external snapping hip syndrome the iliotibial band can be released, allowing the greater trochanter to move freely without snapping. For internal snapping hip syndrome, the Iliopsoas tendon snapping over can be released, to prevent snapping on the iliopectineal eminence or the femoral head[2].
Paediatrics[edit | edit source]
- Hip dysplasia - to assess the chondral damage, which is a key prognostic indicator to decide further surgery. Surgical treatment outcomes are favorable, but with a reoperation rate of 14.1% to 67%.[3]
- Septic arthritis[2]
- Slipped capital femoral epiphysis[2]
- Legg-Calvé-Perthes disease[2]
- Juvenile Chronic Arthritis[6]
- Impingement in young athletes[6]
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures.
Resources[edit | edit source]
add appropriate resources here, including text links or content demonstrating the intervention or technique
References[edit | edit source]
- ↑ NHS. What is an arthroscopy? Available from: https://www.nhs.uk/conditions/arthroscopy/ (Accessed 18/01/2023)
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Jamil M, Dandachli W, Noordin S, Witt J. Hip arthroscopy: Indications, outcomes and complications. Int J Surg. 2018 Jun;54(Pt B):341-344.
- ↑ 3.0 3.1 de Sa D, Lian J, Sheean AJ, Inman K, Drain N, Ayeni O, Mauro C. A Systematic Summary of Systematic Reviews on the Topic of Hip Arthroscopic Surgery. Orthop J Sports Med. 2018 Sep 21;6(9):2325967118796222.
- ↑ Minkara AA, Westermann RW, Rosneck J, Lynch TS. Systematic Review and Meta-analysis of Outcomes After Hip Arthroscopy in Femoroacetabular Impingement. Am J Sports Med. 2019 Feb;47(2):488-500.
- ↑ Griffin DR, Dickenson EJ, Wall PDH, Achana F, Donovan JL, Griffin J, Hobson R, Hutchinson CE, Jepson M, Parsons NR, Petrou S, Realpe A, Smith J, Foster NE; FASHIoN Study Group. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet. 2018 Jun 2;391(10136):2225-2235.
- ↑ 6.0 6.1 6.2 Cross GWV, Sobti AS, Khan T. Hip arthroscopy in osteoarthritis: Is it an option? J Clin Orthop Trauma. 2021 Sep 30;22:101617
