Hip disorders are increasingly recognized among athletic populations. The rigors of military service expose individuals to the same risks as those participating in competitive sports, compounded by potential exposure to violent macrotrauma. This is a retrospective review of prospectively collected data among 62 active duty military personnel (64 hips) with 2–10-year follow-up.Follow-up averaged 47 months (range 24–120 months). The average age was 30 years (range 17–53 years) with 45 males and 17 females; 37 right and 27 left hips. Duration of symptoms prior to arthroscopy averaged 28 months (range 6–168 months). The average improvement was 22 points (pre-op 63; post-op 85) using the 100-point modified Harris hip score and was statistically significant (P < 0.001). Patients were improved after 60 of 64 procedures (94%) and returned to active duty following 52 (80%) and an average of 5 months (range 1 week–15 months). Forty-six (72%) underwent correction of FAI including 27 combined, 17 cam and two pincer lesions. Overall diagnoses and procedures are detailed. One patient underwent repeat arthroscopy and remained improved at 2-year follow-up; none were converted to total hip arthroplasty. There were two minor complications, a transient ulnar nerve neurapraxia and superficial sensory dysesthesias of the foot, both of which resolved within a few days. This is a heterogeneous cohort of pathology, but illustrates that hip disorders may exist among active duty military personnel and may benefit from arthroscopic intervention. A sense of awareness is important for accurate diagnosis and timely treatment.
The infrapatellar fat pad (IFP), also known as Hoffa's fat pad, may be a common site of pain in the knee because of its susceptibility to injury and its vast innervation and vascular supply. Patients who have trauma to the IFP may undergo a process of hemorrhage, inflammation, and fibrosis that may become painful. Patients with Hoffa's disease in whom conservative treatment with medications, physical therapy, and injections has failed may receive significant pain relief and benefit from undergoing arthroscopic subtotal removal of the IFP. We describe a safe and effective way to perform this procedure allowing excellent visualization through the use of a superolateral viewing portal.
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