The Importance of Comprehensive Cam Correction: Radiographic Parameters Are Predictive of Patient-Reported Outcome Measures at 2 Years After Hip Arthroscopy

Lansdown, Drew A.; Kunze, Kyle N.; Ukwuani, Gift; Waterman, Brian R.; Nho, Shane J.

doi:10.1177/0363546518780311

Cited by 35 publications

(26 citation statements)

References 27 publications

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“…All patients experience some degree of pain after hip arthroscopy, ranging from mild to significant in severity, and this important observation has prompted a multitude of studies to investigate a variety of novel analgesia techniques, the factors of which are associated with postoperative pain in this patient population. 4,16,17,30,34,35 The majority (85.7%) of studies in this systematic review established causation between adjunct pain management methods and pain benefits for patients after hip arthroscopy. Of the studies reporting no improvements, both cited no pain benefits and a higher incidence of negative side effects with FIB.…”

Section: Discussionmentioning

confidence: 82%

“…Given the aforementioned evidence, nerve blocks may be an efficacious treatment option to diminish pain in the early postoperative period but should be used with caution given their potential side effects. Future studies may investigate use of nerve blocks on appropriately selected patients given these known risk factors 4,16,17,30,34,35 to provide pain benefit in high-risk cases while minimizing the potential for complications.…”

Section: Discussionmentioning

confidence: 99%

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Adjunct Analgesia Reduces Pain and Opioid Consumption After Hip Arthroscopy: A Systematic Review of Randomized Controlled Trials

et al. 2020

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Background: Patients who undergo hip arthroscopy inevitably experience pain postoperatively; however, the efficacy and safety of adjunct analgesia to prevent or reduce pain are not well-understood. Purpose: To perform a comprehensive qualitative synthesis of available randomized controlled trials evaluating the effect of adjunct analgesia on postoperative (1) pain, (2) opioid use, and (3) length of stay (LOS) in patients undergoing hip arthroscopy. Study Design: Systematic review. Methods: PubMed, OVID/MEDLINE, and Cochrane Controlled Register of Trials were queried for studies pertaining to analgesia interventions for patients undergoing hip arthroscopy. Two authors independently assessed article bias and eligibility. Data pertaining to changes in pain scores, additional analgesia requirements, length of hospital stay, and complications were extracted and qualitatively reported. Network meta-analyses were constructed to depict mean pain, opioid use, and LOS among the 3 analgesia categories (blocks, local infiltration analgesia, and celecoxib). Results: Fourteen level 1 studies were included; 12 (85.7%) reported pain reductions in the immediate and perioperative period after hip arthroscopy. Of the 7 studies that assessed an intervention (2 celecoxib, 1 fascia iliaca block, 1 lumbar plexus block, 1 femoral nerve block, 1 intra-articular bupivacaine, 1 extracapsular bupivacaine) versus placebo, more than half reported that patients who received an intervention consumed significantly fewer opioids postoperatively than patients who received placebo (lowest P value = .0006). Of the same 7 studies, 2 reported significantly shortened LOS with interventions, while 4 reported no statistically significant difference in LOS and 1 did not report LOS as an outcome. Conclusion: The majority of studies concerning adjunct analgesia for patients undergoing hip arthroscopy suggest benefits in pain reduction early in the postoperative period. There is mild evidence that adjunct analgesia reduces postoperative opioid use and currently inconclusive evidence that it reduces length of hospital stay. Furthermore, it appears that local infiltration analgesia may provide the greatest benefits in reductions in pain and opioid consumption. We recommend the use of adjunct analgesia in appropriately selected patients undergoing hip arthroscopy without contraindication who are at a high risk of severe postoperative pain.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Adjunct Analgesia Reduces Pain and Opioid Consumption After Hip Arthroscopy: A Systematic Review of Randomized Controlled Trials

et al. 2020

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“…However, Rego et al [20] in their series of 198 patients with cam FAI did not find any significant functional difference between those treated with either hip arthroscopy or open surgical hip dislocation [20]. Landsdown and colleagues [21] evaluated 707 patients who underwent surgery involving hip arthroscopy, concluding that measurement of the extent of the cam lesion was the strongest predictor of outcome following surgery [21]. The preoperative false profile alpha angle, AP alpha angle and postoperative false profile alpha angle were concluded to be independent predictors of clinical outcome [21].…”

Section: Results Of Surgery For Cam Deformitymentioning

confidence: 96%

“…Landsdown and colleagues [21] evaluated 707 patients who underwent surgery involving hip arthroscopy, concluding that measurement of the extent of the cam lesion was the strongest predictor of outcome following surgery [21]. The preoperative false profile alpha angle, AP alpha angle and postoperative false profile alpha angle were concluded to be independent predictors of clinical outcome [21].…”

Section: Results Of Surgery For Cam Deformitymentioning

confidence: 99%

Managing Cam FAI: Intermediate Hip Arthroscopy

Kumar

Khokher

Khanduja

2020

ESSKA Instructional Course Lecture Book

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“…2 Rehabilitation protocols at our tertiary hip preservation center are comprehensive, yet relatively standardized among patients. 3,8,9 The senior surgeon (S.J.N.) utilizes the same standardized arthroscopic hip protocol, and this is shared with both patients and therapists in order to maintain uniformity.…”

Section: Mingjin Zhong MDmentioning

confidence: 99%