Hip Arthroscopy for Femoroacetabular Impingement: The Changing Nature and Severity of Associated Complications Over Time

Park, Myung-Sik; Yoon, Sun Jung; Chung, Woo-Chul

doi:10.1016/j.arthro.2014.03.017

Cited by 60 publications

(46 citation statements)

References 27 publications

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“…Prior studies have examined the rate of iatrogenic injuries in hip arthroscopy and concluded that the rate of such injuries is correlated with the learning curve of the procedure. [6][7][8][9][10] These studies have demonstrated that as the surgeon becomes more experienced with hip arthroscopy, the frequency of iatrogenic complications will diminish. Specifically, Hoppe et al 10 found that after 30 hip arthroscopies, the operative time and complication rate significantly declined.…”

Section: Discussionmentioning

confidence: 99%

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Complications in Hip Arthroscopy

Weber

Harris²,

Nho³

2015

Sports Medicine and Arthroscopy Review

103

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The primary objective of this study was to determine the minor and major complication rate of hip arthroscopy. The secondary objective was to provide strategies for avoiding complications. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and checklist. Therapeutic hip arthroscopy investigations that reported on adverse events or complications were included. Narrative and other systematic reviews, meta-analyses, conference abstracts or proceedings, and level V evidence studies were excluded. No follow-up minimum was imposed. The results yielded 53 studies (8189 hip arthroscopies in 8071 subjects). Most studies were level IV evidence (74%) with a mean of 2.2±2.1 years follow-up. Femoroacetabular impingement (FAI) and labral pathology were the 2 most common indications for surgery, and osteochondroplasty for FAI and labral treatment were the 2 most common procedures performed. The minor and major complication rates were 7.9% and 0.45%, respectively. Iatrogenic chondrolabral damage and temporary nerve injury were the 2 most common minor complications. Extra-articular fluid extravasation was the most common major complication encountered. Minor complications associated with hip arthroscopy are generally technical in nature and may be related to the learning curve associated with hip arthroscopy. As surgeon experience increases and patient selection improves, a corresponding decline should be observed in minor complications. Strategies to prevent complications include careful preoperative planning, appropriate surgical indications, attention to detail in the operating room, and proper postoperative rehabilitation.

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Section: Discussionmentioning

confidence: 99%

“…4,5 However, arthroscopic hip surgery has a steep and well-documented learning curve. [6][7][8][9][10] Both during and after the learning curve, the surgeon must be able to recognize, manage, and prevent complications with hip arthroscopy. Complications may include both intraoperative technical errors and postoperative adverse events.…”

mentioning

confidence: 99%

Complications in Hip Arthroscopy

Weber

Harris²,

Nho³

2015

Sports Medicine and Arthroscopy Review

103

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“…The types of complications change with the level of experience (e.g. inadequate cam resection) [106]. The anatomy in the typical adult patient tends to be quite uniform, whereas in the pediatric patient, the underlying anatomy is more frequently unique due to the underlying developmental disorders and previous treatment.…”

Section: Resultsmentioning

confidence: 99%

The use of hip arthroscopy in the management of the pediatric hip

Roy

2015

J Hip Preserv Surg

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Arthroscopy of the pediatric hip began in 1977 with a publication by Gross. Interest was relatively slow to develop in the 1980s and 1990s. Coupled with the success of hip arthroscopy in the adult, interest heightened in applying the procedure to a variety of pediatric hip disorders, given that the alternative was an open surgical hip dislocation. The success of this initial group of pediatric hip arthroscopist’s has further expanded the application of hip arthroscopy as the primary or adjunct procedure for the management of intra-articular problems of the pediatric hip.

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“…There have been several missed opportunities with respect to FAI at this stage, such as, lack of consensus about surgical indications and patient selection criteria, lack of standardized outcome definitions and measurement tools, and no formula to assess procedure quality and surgeon performance [5]. In addition, there is no established course for training or mentoring surgeons new to the technique—a pertinent issue in view of the potential complications associated with the hip arthroscopy learning curve [32–35]. …”

Section: Surgical Innovation and The Ideal Collaborativementioning

confidence: 99%

Surgical innovation and safety: femoroacetabular impingement and the IDEAL collaborative framework:

Lee

2015

J Hip Preserv Surg

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Operative treatment of femoroacetabular impingement (FAI) is a relatively new, yet rapidly expanding surgical innovation. Although the practice of surgery is inherently innovative, there is no clear distinction between minor technical variation and true modification that warrants testing. This raises important questions about how new procedures should be evaluated before being broadly disseminated. The IDEAL Collaborative is a consortium that promotes safe and responsible translation of research into clinical practice. The collaborative has delineated the typical stages of evolution of new interventional technologies, and the type of study designs appropriate for each stage. This report examines the surgical treatment of FAI as a case study of the IDEAL framework and discusses both missed and future opportunities for critical assessment.

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Hip Arthroscopy for Femoroacetabular Impingement: The Changing Nature and Severity of Associated Complications Over Time

Cited by 60 publications

References 27 publications

Complications in Hip Arthroscopy

Complications in Hip Arthroscopy

The use of hip arthroscopy in the management of the pediatric hip

Surgical innovation and safety: femoroacetabular impingement and the IDEAL collaborative framework:

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