Complications in Hip Arthroscopy

Weber, Alexander E.; Harris, Joshua D.; Nho, Shane J.

doi:10.1097/jsa.0000000000000084

Cited by 103 publications

(35 citation statements)

References 51 publications

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“…They also found decreased conversion rates from 2005 to 2010, which might illustrate changes in indications for surgery and changes in surgical procedures during hip arthroscopy. A systematic review by Weber et al described a 6.3% re-operation rate after hip arthroscopy in a cohort consisting of more than 6000 from 92 studies [27]. The majority of these re-operations were, respectively, revision hip arthroscopies in 1.9% and conversion to THA in 2.9% of the patients.…”

Section: Discussionmentioning

confidence: 99%

Danish Hip Arthroscopy Registry (DHAR): the outcome of patients with femoroacetabular impingement (FAI)

Lund

Mygind-Klavsen

Nielsen

et al. 2017

Journal of Hip Preservation Surgery

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The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM). Peri-operative data and Patient Reported Outcome Measures (PROM) data from DHAR between January 2012 and November 2015 were extracted. Radiological pincer-type FAI was defined as LCE > 35° and cam FAI as alpha-angle > 55°. These data were combined with FAI surgical data such as osteochondroplasty and labral repair or resection. PROMs consisting of HAGOS, EQ-5 D, HSAS and NRS pain scores were submitted online by the patients pre-operatively and at 1 and 2-years follow-up. 2054 FAI procedures in 1835 patients were included in this study (219 patients had bilateral procedures performed). HAGOS demonstrated significant improvement in all subscales at follow up. EQ-5 D demonstrated improvement after 1 and 2 years from 0.66 pre-op to 0.78 at 2 years. HSAS improved significantly from 2.5 to 3.3. Pain score data demonstrated improvement in NRS-rest 39 to 17 and NRS Walk 49 to 22 at follow-up. We conclude that patients with FAI undergoing hip arthroscopy experience improvement in pain, quality of life and also in function and sports related outcome measures during the first 2 years after surgery.

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Section: Discussionmentioning

confidence: 99%

Danish Hip Arthroscopy Registry (DHAR): the outcome of patients with femoroacetabular impingement (FAI)

Lund

Mygind-Klavsen

Nielsen

et al. 2017

Journal of Hip Preservation Surgery

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“…11 While cases of dislocation and subluxation following hip arthroscopy are rare, they are discussed frequently at hip arthroscopy conferences, which suggests that these complications are underreported. 15,42 There have been at least 8 published case reports documenting postoperative hip dislocation after hip arthroscopy. 3,6,12,21,23,31,32,35 This is a potentially devastating complication, and one needs to be acutely aware of the risk factors associated with it; these include open capsulotomy without repair, acetabular dysplasia, hypermobility, or ligamentous laxity.…”

Section: Discussionmentioning

confidence: 99%

Generalized Joint Hypermobility Is Predictive of Hip Capsular Thickness

Devitt

Smith

Stapf

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:The pathomechanics of hip microinstability are not clearly defined but are thought to involve anatomical abnormalities, repetitive forces across the hip, and ligamentous laxity.Purpose/Hypothesis:The purpose of this study was to explore the relationship between generalized joint hypermobility (GJH) and hip capsular thickness. The hypothesis was that GJH would be predictive of a thin hip capsule.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A prospective study was performed on 100 consecutive patients undergoing primary hip arthroscopy for the treatment of hip pain. A Beighton test score (BTS) was obtained prior to each procedure. The maximum score was 9, and a score of ≥4 was defined as hypermobile. Capsular thickness at the level of the anterior portal, corresponding to the location of the iliofemoral ligament, was measured arthroscopically using a calibrated probe. The presence of ligamentum teres (LT) pathology was also recorded.Results:Fifty-five women and 45 men were included in the study. The mean age was 32 years (range, 18-45 years). The median hip capsule thickness was statistically greater in men than women (12.5 and 7.5 mm, respectively). The median BTS for men was 1 compared with 4 for women (P < .001). A statistically significant association was found between BTS and capsular thickness; a BTS of <4 is strongly predictive of having a capsular thickness of ≥10 mm, while a BTS ≥4 correlates with a capsular thickness of <10 mm. There was a statistically greater incidence of LT tears in patients with a capsular thickness of ≤7.5 mm and a BTS of ≥4 (P < .001).Conclusion:Measurement of the GJH is highly predictive of hip capsular thickness. A BTS of <4 correlates significantly with a capsular thickness of ≥10 mm, while a BTS ≥4 correlates significantly with a thickness of <10 mm.

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“…A systematic review by Weber et al described a rate of reoperations after hip arthroscopy at 6.3% in a cohort consisting of more than 6000 from 92 studies [27]. The majority of these reoperations were, respectively, revision hip arthroscopy in 1.9% and conversion to THA in 2.9% of the patients.…”

Section: Discussionmentioning

confidence: 99%

Cartilage status in FAI patients – results from the Danish Hip Arthroscopy Registry (DHAR)

Nielsen

Lind

2017

SICOT-J

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Introduction: The femoroacetabular impingement (FAI) morphology is associated with specific cartilage lesions, which are suspected to be early stages of the osteoarthritic development, which can be the end result of FAI. The cartilage status of FAI afflicted hip joints at the time of arthroscopic management is not fully elucidated. This study from the Danish Hip Arthroscopy Registry (DHAR) will try to show data on the cartilage status from a large cohort. Data from a national registry potentially represent large amounts of population-based epidemiological information from multiple centres and surgeons. Therefore, outcome data might be more reliable for a specific surgical intervention. Methods: This study includes patients operated for symptomatic FAI from January 2012 until December 31st 2013, with a minimum of two-year follow-up and being registered in DHAR. The extent of cartilage damage at the time of surgery is reported and the Patient Related Outcome Measures (PROM) outcome data are presented. Results: Data from a total of 686 FAI procedures in 1082 patients from January 2012 until December 31st 2013 were extracted from DHAR. Cartilage injuries were found in 88% of cases, mainly on the acetabular side. Overall PROM including pain scores improved significantly from preoperative status to follow-up one and two years postoperatively. The Copenhagen Hip and Groin Outcome Score (HAGOS), Hip Sports Activity Scale (HSAS) and global hip function showed less improvements in patients with more severe acetabular cartilage injury. Discussion: The majority of patients with femoroacetabular impingement (FAI) undergoing hip arthroscopy have significant cartilage changes at the time of surgery primarily at the acetabulum and to a lesser degree at the femoral head. During FAI surgery the majority of patients have cartilage debridement performed but rarely cartilage repair. The presence of severe cartilage injury at the time of arthroscopic FAI surgery results in reduced subjective outcome and hip function.

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Complications in Hip Arthroscopy

Cited by 103 publications

References 51 publications

Danish Hip Arthroscopy Registry (DHAR): the outcome of patients with femoroacetabular impingement (FAI)

Danish Hip Arthroscopy Registry (DHAR): the outcome of patients with femoroacetabular impingement (FAI)

Generalized Joint Hypermobility Is Predictive of Hip Capsular Thickness

Cartilage status in FAI patients – results from the Danish Hip Arthroscopy Registry (DHAR)

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