Bilateral Hip Arthroscopy Under the Same Anesthetic for Patients With Symptomatic Bilateral Femoroacetabular Impingement: 1-Year Outcomes

Mei-Dan, Omer; McConkey, Mark O.; Knudsen, Joshua S.; Brick, Matthew J.

doi:10.1016/j.arthro.2013.09.079

Cited by 28 publications

(40 citation statements)

References 25 publications

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“…They examined 3 groups of patients: 12 patients with bilateral simultaneous hip arthroscopy for FAI; a group of 24 matched for age, sex, and alpha angle; and the rest of 81 patients undergoing bilateral operations. Interestingly, average age was significantly younger than the age of patients in the study by Mei-Dan et al, 2 and microfractures were not performed in any of the cases. Also, the simultaneous group was younger than the unmatched group, but there was no difference in treated pathology and procedures.…”

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confidence: 66%

“…In a previous study, Mei-Dan et al 2 compared the outcomes of simultaneous and staged bilateral hip arthroscopies in the treatment of femoroacetabular impingement (FAI). They found no differences between groups in the Nonarthritic Hip Score and WOMAC scores at 6 and 12 months, although there was a significant difference in early postoperative mobilization.…”

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confidence: 99%

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Editorial Commentary: Shall We Just Get It All Done With? Simultaneous Versus Staged Bilateral Hip Arthroscopy

Konyves¹

2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Simultaneous bilateral hip arthroscopies have comparable patient-reported outcomes and little risk of complications when compared with staged bilateral hip arthroscopies in the treatment of femoroacetabular impingement. There will always be a selection bias, however: rehabilitation requiring 4-point gait will be more difficult, and some would consider that a simultaneous bilateral operation is more suited for the young, motivated, physically fit patient.

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Section: See Related Article On Page 1300mentioning

confidence: 66%

Section: See Related Article On Page 1300mentioning

confidence: 99%

Editorial Commentary: Shall We Just Get It All Done With? Simultaneous Versus Staged Bilateral Hip Arthroscopy

Konyves¹

2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Enabling factors to the performance of safe and efficacious single-stage bilateral hip arthroscopy 4 , 5 include the following: proper patient selection, setup with supine arthroscopy with bilateral mobile leg spars, rapid traction and surgical times, C-arm positioned between legs, and postoperative rehabilitation with immediate weight bearing. Each of these topics will be discussed in turn.…”

Section: Discussionmentioning

confidence: 99%

“… 3 Emerging evidence has supported this offering as efficacious and safe. 4 , 5 We present our current techniques that have evolved in this Technical Note.…”

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confidence: 99%

“…Emerging studies have supported our experience of simultaneous hip arthroscopy as a safe and efficient alternative to staged hip arthroscopy. 4 , 5 We explain to each patient that disadvantages to undergoing single-stage surgery include the inability to “test the waters” to determine if, in their individual experience, the initial hip arthroscopy provides an unacceptable outcome. One cannot undo surgery; if, for example, a right hip arthroscopy yields a real or perceived unsatisfactory outcome, the patient has the option to not proceed with contralateral hip arthroscopy only if he or she opts for 2-stage surgery.…”

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Simultaneous Bilateral Hip Arthroscopy

Matsuda

Ching

Matsuda

2017

Arthroscopy Techniques

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Many patients are afflicted with painful conditions affecting both hips, most commonly femoroacetabular impingement. Some patients prefer the advantage of undergoing a single surgical procedure and anesthetic followed by a single postoperative rehabilitation program. We present a Technical Note on single-stage bilateral hip arthroscopy. This Technical Note reports on key steps enabling safe and efficient performance of bilateral arthroscopic acetabuloplasty, labral refixation, femoroplasty, and dynamic testing while limiting traction times and facilitating rapid transition to the second hip arthroscopic surgery. Enabling factors include supine positioning with bilateral mobile leg spars, rapid surgical and hip traction times, and postoperative rehabilitation with immediate weight bearing as tolerated. A rationale for deciding which hip should undergo arthroscopy first is also offered. Concurrent bilateral hip arthroscopy is a viable option for select patients and experienced surgical teams, enabling potentially expedited recovery and return to work or sport with inherent cost savings.

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Bilateral hip arthroscopy for treating femoroacetabular impingement: a systematic review

Kumar

Shanmugaraj

Kay

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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PurposeFemoroacetabular impingement (FAI) is a hip disorder which can often present bilaterally. The purpose of this systematic review was to explore the current practices for bilateral hip arthroscopy in treating FAI as they relate to outcomes and complications. MethodsThis review has been conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA). The electronic databases PubMed, MEDLINE, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched from data inception to October 18th, 2020. The Methodological Index for Non‐randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively. ResultsOverall, 19 studies were identified, comprising 957 patients (48.6% male) with a mean age of 27.9 ± 7.1 years and a mean follow‐up of 31.7 ± 20.8 months. The majority of patients were treated with a staged bilateral hip arthroscopy (78.5%) with a mean duration between surgeries of 7.1 ± 4.0 months. Significant preoperative‐to‐postoperative improvements for clinical outcomes such as pain, hip function, and health‐related daily living as well as radiographic outcomes were reported in six studies for staged procedures (p < 0.05) and three studies for simultaneous procedures (p < 0.02). Significant improvements in patient‐reported outcomes (e.g., HOS‐ADL, Pain, HOS‐SS, mHHS, and NAHS) were found in favor of those undergoing a shorter delay between surgeries in three studies (i.e., < 3, 10 or 17 months) (p < 0.05) compared to those who had delayed surgeries (i.e., > 3, 10, or 17 months). The overall complication rate was 10.1% (97/957). ConclusionsBilateral surgery for FAI yields improved outcomes postoperatively and complication rates similar to unilateral surgery. The overall complication rate was 10.1% with the most common complication being revision surgery. Staged bilateral surgery is more commonly performed than simultaneous surgery. Clinicians should consider preoperative imaging, clinical history, and patient values when deciding between staged and simultaneous procedures for bilateral FAI surgery. Future studies are required to determine the optimal indications for simultaneous versus staged procedures, as well as the ideal timing between surgeries for the latter. Level of evidenceLevel IV.

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Bilateral Hip Arthroscopy Under the Same Anesthetic for Patients With Symptomatic Bilateral Femoroacetabular Impingement: 1-Year Outcomes

Cited by 28 publications

References 25 publications

Editorial Commentary: Shall We Just Get It All Done With? Simultaneous Versus Staged Bilateral Hip Arthroscopy

Editorial Commentary: Shall We Just Get It All Done With? Simultaneous Versus Staged Bilateral Hip Arthroscopy

Simultaneous Bilateral Hip Arthroscopy

Bilateral hip arthroscopy for treating femoroacetabular impingement: a systematic review

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