Case Report: Osteonecrosis of the Femoral Head after Hip Arthroscopy

Scher, Danielle L.; Belmont, Philip J.; Owens, Brett D.

doi:10.1007/s11999-010-1256-1

Cited by 50 publications

(26 citation statements)

References 18 publications

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“…Theoretically, osteonecrosis after hip arthroscopy may result from traction on vessels supplying the femoral head, direct injury to such vessels during portal entrance, raised intra-articular pressure, prolonged operating time, and damage to vessels during bony resection or osteochondroplasty for FAI. Isolated case reports of osteonecrosis after hip arthroscopy have been reported in non-femoroplasty cases and have been attributed to vascular compromise from traction [22][23][24] and/or excessive intra-articular fluid pressure. 23 Recent anatomic studies suggest variable contribution to femoral head vascularity from the inferior gluteal artery.…”

Section: Discussionmentioning

confidence: 99%

Hip Arthroscopy for Challenging Deformities: Posterior Cam Decompression

Matsuda

Hanami

2013

Arthroscopy Techniques

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Since the classic description of cam femoroacetabular impingement occurring in the anterolateral quadrant of the proximal femur, there has been growing evidence of cam impingement extending outside of this region. Although anteromedial cam decompression may be performed, posterior cam decompression is at higher theoretic risk of vascular embarrassment with osteonecrosis and/or tensile failure with fracture, leading some investigators to believe that these major deformities require open surgical correction. We present a less invasive method of arthroscopic posterior cam decompression using the modified midanterior portal while avoiding the posterolateral vasculature of the proximal femur.

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Section: Discussionmentioning

confidence: 99%

Hip Arthroscopy for Challenging Deformities: Posterior Cam Decompression

Matsuda

Hanami

2013

Arthroscopy Techniques

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“…Nursing staff should note the onset of traction because there have been case reports of avascular necrosis from prolonged traction. [12][13][14] After sterile preparation and draping, the anterior superior iliac spine is marked, and a vertical line is extended down the thigh toward the center of the knee. The greater trochanter is marked as well.…”

Section: Surgical Techniquementioning

confidence: 99%

Capsular Plication for Treatment of Iatrogenic Hip Instability

Levy

Grzybowski

Salata

et al. 2015

Arthroscopy Techniques

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The most commonly reported reasons for persistent hip pain after hip arthroscopy are residual femoroacetabular impingement, dysplasia and dysplasia variants, or extra-articular impingement. There are some cases in which the underlying osseous pathomorphology has been appropriately treated, and the cause of persistent hip pain can be soft-tissue injuries such as chondrolabral tears or capsular abnormalities. Capsular defects after hip arthroscopy may suggest an alteration of the biomechanical properties of the iliofemoral ligament and lead to iatrogenically induced hip instability. There are a growing number of biomechanical and clinical studies showing the importance of capsular management during hip arthroscopy. We describe the workup, examination under anesthesia, diagnostic arthroscopy, and technique of capsular plication for iatrogenic instability of the hip.

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“…This complication needs special attention during surgery because it can be fatal due to abdominal compartment syndrome (33). Some rare complications such as osteonecrosis, postoperative dislocation of the femoral head, and femoral neck fractures have been described in case reports (34)(35)(36).…”

Section: Complicationsmentioning

confidence: 99%

The state of the art in arthroscopic hip surgery

et al. 2014

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: Hip arthroscopy is among the most rapidly evolving arthroscopic techniques in the last decade and offers the benefits of being both a minimally invasive procedure and an excellent diagnostic tool. Improvements in instrumentation and surgical skills have advanced our ability to accurately diagnose and treat various conditions of the hip joint, and hip arthroscopy has elucidated several pathologies that cause disabling symptoms. Many of these conditions were previously unrecognized and left untreated. The indications for hip arthroscopy include the management of early osteoarthritis, synovial disorders (e.g., synovial osteochondromatosis), labral tears, chondral lesions, and femoroacetabular impingement (FAI), which is increasingly recognized as a disorder that can lead to the development of early cartilage and labral injury. A better understanding of hip arthroscopy, including the anatomy, improved surgical techniques, indications, and complications of the procedure, is essential for its success. This review article discusses the state of the art of arthroscopic hip surgery. J. Med. Invest. 61 : 226-232, August, 2014

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Case Report: Osteonecrosis of the Femoral Head after Hip Arthroscopy

Abstract: We suspect this case of femoral head osteonecrosis after hip arthroscopy was caused by traction used in the procedure.

Cited by 50 publications

References 18 publications

Hip Arthroscopy for Challenging Deformities: Posterior Cam Decompression

Hip Arthroscopy for Challenging Deformities: Posterior Cam Decompression

Capsular Plication for Treatment of Iatrogenic Hip Instability

The state of the art in arthroscopic hip surgery

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