Recent advances and future trends in hip arthroscopy

Abstract

Hip arthroscopy (HA) is a well-established minimally invasive technique used to treat a wide range of conditions. Technological innovations have expanded the scope of HA and improved its outcomes. Several authors have described post-less arthroscopy to overcome the risk associated with the use of the perineal post for obtaining distraction of the hip joint. Instrument refinement has improved the efficacy of labral repair and reconstruction. Several treatment strategies are available for articular cartilage defects including ACI, MACI, and mosaicplasty, to name a few. Some authors have suggested that ligamentum teres reconstruction is helpful in young active patients with femoroacetabular impingement experiencing subluxation of the hip joint. The incorporation of new technology and patient-specific approaches represents a new way to improve HA outcomes. Virtual reality simulation training is the key to overcoming the steep learning curve associated with HA and to achieve high standards early in a surgeon’s career. Computer-based navigation surgery may be the key to accurately resecting the cam deformity and reducing the rate of revision surgery due to inaccurate resection at the index procedure. Assessment and optimization of the baseline psychological state and effective pre-habilitation may also improve outcome measures. Adequate stratification of the pathology and assessment of baseline patient characteristics influences the long-term outcome following the HA.

The growth of hip preservation as a speciality

“…Progressing technological advancements and the use of artificial intelligence in medicine are likely to influence the hip preservation growth trajectory. Computer‐assisted surgeries allow surgeons not only to create a precise pre‐operative plan, but also increase accuracy of their implementation during surgery via complex navigation/robotic systems [30]. Likewise, the ability to predict individual patient outcomes using artificial intelligence and patient stratification preoperatively leading to personalised medicine holds great promise [10].…”

The State of Hip Arthroscopy in Russia: Assessment Based on a Sociological Survey of Doctors

“…Лечебно-диагностическая артроскопия тазобедренного сустава -малотравматичный хирургический способ устранения деформации вертлужной впадины и проксимального отдела бедренной кости, которые участвуют в развитии патомеханического процесса -фемороацетабулярного импинджмента (ФАИ). Иными показаниями к выполнению данного вмешательства на сегодняшний день являются повреждение суставной губы вертлужной впадины, хряща головки бедренной кости, круглой связки, синдром подвздошно-поясничной мышцы, подостный импинджмент, удаление хондромных тел [1,2].…”

Use of Warmed Irrigation Solution in Arthroscopy: a Systematic Literature Review and a Perspective of Ten Years of Experience in Hip Arthroscopy

“…In the last two decades, hip arthroscopy has emerged as a less invasive tool to manage intraarticular, and extraarticular pathology, such as femoroacetabular impingement (FAI), labral and chondral injuries, ligamentum teres injuries, iliopsoas impingement, sub-spinous impingement, and the indications continue to expand 1 , such as the endoscopic release of the sciatic nerve, a technique which we have implemented as a working group in recent years.…”

“…4,8,9,12,13 Managing the patient's temperature during shoulder and hip arthroscopy poses unique challenges. Extravasation of irrigation fluid is common and is not just limited to the capsule of a joint, 1,4,15,16 but extravasation of fluid is minimal during knee arthroscopy because the surgical site is distal to the body core. Therefore, warming irrigation fluids during knee arthroscopy may not minimize the risk of hypothermia, decrease the drop in temperature, increase the lowest temperature, or reduce the risk of shivering.…”