Hip arthroscopy for extra-articular hip disease

Reich, Michael S.; Shannon, Claire; Tsai, Eugene; Salata, Michael J.

doi:10.1007/s12178-013-9177-8

Cited by 25 publications

(13 citation statements)

References 75 publications

(170 reference statements)

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“…Hip arthroscopy has numerous indications with femoroacetabular impingement (FAI) being one of the most common [ 1–3 ]. FAI is often classified as either cam or pincer type; though combinations of both types exist in clinical practice [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

Haldane

Ekhtiari

et al. 2017

Journal of Hip Preservation Surgery

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The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior–posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence: Level IV, Systematic Review of Level I–IV Studies.

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Section: Introductionmentioning

confidence: 99%

Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

Haldane

Ekhtiari

et al. 2017

Journal of Hip Preservation Surgery

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“…S ubspine impingement (SSI) is a type of extraarticular hip impingement resulting from abnormal contact between the anterior inferior iliac spine (AIIS) and femoral neck or headeneck junction. 1,2 SSI commonly co-occurs with intra-articular femoroacetabular impingement (FAI), and successful identification and correction of a prominent subspine has been shown to be predictive of greater improvement after primary hip arthroscopy for FAI syndrome. [3][4][5] Hetsroni et al 6 defined 3 types of AIIS morphologies in SSI: type 1, which appears radiographically normal and describes a smooth ileal wall between the AIIS and acetabular rim; type II, which extends to the level of the acetabular rim; and type III, which protrudes distal to the anterosuperior acetabular rim.…”

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confidence: 99%

“…Subspine impingement (SSI) is a type of extra-articular hip impingement resulting from abnormal contact between the anterior inferior iliac spine (AIIS) and femoral neck or head–neck junction. 1 , 2 SSI commonly co-occurs with intra-articular femoroacetabular impingement (FAI), and successful identification and correction of a prominent subspine has been shown to be predictive of greater improvement after primary hip arthroscopy for FAI syndrome. 3 , 4 , 5 …”

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confidence: 99%

Capsule-Preserving Approach to Arthroscopic Decompression of the Anterior Inferior Iliac Spine

Westermann

Schaver

Larson

2021

Arthroscopy Techniques

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Hip arthroscopy techniques have evolved to treat a wide range of extra-articular pathologies. Subspine impingement commonly occurs in femoroacetabular impingement, particularly in athletes with a high range of motion, patients with low degrees of femoral version, and those with large subspine deformities. A reliable technique that preserves the hip capsule would be helpful for hip arthroscopy surgeons. This note details our technique using pericapsular windows proximal to the interportal capsulotomy to access and decompress a subspine deformity in the setting of hip femoroacetabular impingement.

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“…S ubspine impingement (SSI) is an extra-articular impingement condition that can contribute to hip pain without or in conjunction with femoroacetabular impingement (FAI). It results from abnormal contact between the anterior inferior iliac spine (AIIS) and proximal femur (1). As treatment techniques for FAI advance, interest in understanding the pathomorphologic features of SSI has grown because SSI has been recognized as a cause of failed FAI treatment and persistent hip pain after arthroscopic surgery (2)(3)(4).…”

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confidence: 99%

MRI Assessment of Subspine Impingement: Features beyond the Anterior Inferior Iliac Spine Morphology

et al. 2019

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Background:The MRI manifestations of subspine impingement (SSI) other than morphologic features of anterior inferior iliac spine (AIIS) have not been extensively explored and validated.Purpose: To determine the MRI findings associated with SSI, including AIIS morphologic features, femoral distal cam, and associated soft-tissue injuries. Materials and Methods:This is a retrospective study of symptomatic patients who underwent arthroscopic treatment for femoroacetabular impingement between December 2014 and March 2017, with preoperative MRI within 6 months before surgery. The SSI group included patients with clinical and intraoperative findings of SSI; the remaining patients comprised the non-SSI group. Preoperative MRI findings were independently assessed by two radiologists who were blinded to clinical information. Interreader agreement was assessed, and multivariable logistic regression was also used.Results: A total of 62 patients (mean age 6 standard deviation, 42.1 years 6 11.9; 38 women) were included. SSI was diagnosed in 20 of the 62 patients (32%) (mean age, 43 years 6 12); 42 patients (68%) did not have SSI (mean age, 41 years 6 10). Reader 1 detected distal cam in 16 of the 20 patients with SSI (80%) and eight of the 42 patients without SSI (19%), and reader 2 detected distal cam in 15 of the 20 patients with SSI (75%) and eight of the 42 patients without SSI (19%) (P , .001 for both). Reader 1 detected signs of impingement on the distal femoral neck (IDFN) in 18 of the 20 patients with SSI (90%) and seven of the 42 patients without SSI (16%), and reader 2 detected signs of IDFN in 13 of the 20 patients with SSI (65%) and nine of the 42 patients without SSI (21%) (P , .001 and P = .001, respectively). Reader 1 detected superior capsular edema in 15 of 20 patients with SSI (75%) and three of 42 patients without SSI (7%), and reader 2 detected superior capsular edema in 17 of 20 patients with SSI (85%) and 22 of 42 patients without SSI (52%) (P , .001 and P = .02, respectively). Distal cam was a predictor of SSI after adjustment for IDFN. Interreader agreement was substantial for distal cam (k = 0.80) and moderate for IDFN (k = 0.50). Conclusion:Soft-tissue injuries and osseous findings other than morphologic features of the anterior inferior iliac spine were associated with subspine impingement.

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Hip arthroscopy for extra-articular hip disease

Abstract: The increasing popularity and success

Cited by 25 publications

References 75 publications

Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

Capsule-Preserving Approach to Arthroscopic Decompression of the Anterior Inferior Iliac Spine

MRI Assessment of Subspine Impingement: Features beyond the Anterior Inferior Iliac Spine Morphology

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