No abstract

The objectives of this study are to survey the weight-bearing limitation practices and delay for returning to running and impact sports of high volume hip arthroscopy orthopedic surgeons. The study was designed in the form of expert survey questionnaire. Evidence-based data are scares regarding hip arthroscopy post-operative weight-bearing protocols. An international cross-sectional anonymous Internet survey of 26 high-volume hip arthroscopy specialized surgeons was conducted to report their weight-bearing limitations and rehabilitation protocols after various arthroscopic hip procedures. The International Society of Hip Arthroscopy invited this study. The results were examined in the context of supporting literature to inform the studies suggestions. Four surgeons always allow immediate weight bearing and five never offer immediate weight bearing. Seventeen surgeons provide weight bearing depending on the procedures performed: 17 surgeons allowed immediate weight bearing after labral resection, 10 after labral repair and 8 after labral reconstruction. Sixteen surgeons allow immediate weight bearing after psoas tenotomy. Twenty-one respondents restrict weight bearing after microfracture procedures for 3–8 weeks post-operatively. Return to running and impact sports were shorter for labral procedures and bony procedures and longer for cartilaginous and capsular procedures. Marked variability exists in the post-operative weight-bearing practices of hip arthroscopy surgeons. This study suggests that most surgeons allow immediate weight bearing as tolerated after labral resection, acetabular osteoplasty, chondroplasty and psoas tenotomy. For cartilage defect procedures, 6 weeks or more non-weight bearing is suggested depending on the area of the defect and lateral central edge angle. Delayed return to sports activities is suggested after microfracture procedures. The level of evidence was Level V expert opinions.

The anterior inferior iliac spine (AIIS) has variable morphology that correlates with hip range of motion. Subspinal impingement is an extracapsular cause for femoroacetabular impingement (FAI) and is clinically significant because it results in decreased range of motion and groin pain with flexion-based activity. In symptomatic patients with AIIS extension to or below the acetabular rim, AIIS decompression is considered part of an FAI corrective procedure. A consistent exposed bony area on the anterior and inferomedial aspect of the AIIS serves as a "safe zone" of resection allowing for decompression with preservation of the origin of the rectus femoris tendon. This surgical note describes a technique for AIIS decompression. The goal for low AIIS osteoplasty is to resect the AIIS to 2 burr widths (using a 5.5-mm burr) above the acetabular rim, achieving an 11-mm clearance, creating a type I AIIS. The resultant flat anterior acetabular surface between the most anteroinferior prominent point of the AIIS and the acetabular rim allows for free movement of the hip joint without impingement. Careful execution of AIIS decompression can alleviate clinical symptoms of FAI and restore function to the hip joint.