The use of platelet-rich plasma to augment conservative and surgical treatment of hip and pelvic disorders

Kraeutler, Matthew J.; Garabekyan, T.; Mei-Dan, Omer

doi:10.32098/mltj.03.2016.19

Cited by 28 publications

(9 citation statements)

References 55 publications

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“…Decreased femoral anteversion was also associated with failure, owing to inherent rotational deformity being the cause of impingement and not the typical mechanical impingement seen in most cases of FAI. 16 These results appear to be consistent with our data on RHA; both lower preoperative patient-reported outcome measures (PROMs) and a decreased change in the alpha angle appear to be predictive of failure in RHA. A limitation of our study was that femoral version data were limited in our cohort.…”

Section: Discussionsupporting

confidence: 89%

Radiographic Factors Associated With Failure of Revision Hip Arthroscopy

Bloom¹,

Yu²,

Kingery³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To identify clinical and radiographic factors associated with failure of revision hip arthroscopy (RHA). Methods A database was used to identify patients who underwent primary hip arthroscopy and revision hip arthroscopy (RHA) from January 2007 to December 2017 for the indication of femoroacetabular impingement and failure of the index procedure, respectively. The primary outcome was defined as the change, or difference, in the preoperative to postoperative alpha angle between patients with successful RHA and those with failed RHA. Failure was defined as reoperation on the operative hip for any indication or a modified Harris Hip Score (mHHS) of less than 70 at the 1-year postoperative time point. All patients had a minimum of 2 years’ follow-up from the date of revision hip surgery. Patients with a history of revision were divided into those with failed revisions and those with successful revisions. The inclusion criteria for failed revision included a history of subsequent revision surgery (or arthroplasty) or an mHHS of less than 70 at final follow-up. Results The study included 26 patients, comprising 8 (31%) with failed RHA and 18 (69%) with successful revision. The failure group showed a significantly smaller decrease in the alpha angle with surgery, measured on the Dunn view, compared with the success group. When the preoperative alpha angle was held constant, each 1° increase in the difference between the preoperative and postoperative alpha angles achieved during surgery was associated with a 17% decrease in the odds of failure. Patients included in the success group had both a higher preoperative mHHS (44.2 ± 8.6 vs 34.7 ± 9.6) and a higher postoperative mHHS (83.2 ± 8.3 vs 62.3 ± 14.2) than patients with failed RHA. There was a statistically significant difference in the frequency of patients who achieved the patient acceptable symptomatic state of +74.0 between the failure (25%) and success (83%) groups; 88% of patients in the failure group met the minimal clinically important difference, whereas 100% of patients in the success group (n = 18) met it. Conclusions Complete resection of cam lesions as determined by changes in the alpha angle, anterior offset, and head-neck ratio when measured on the Dunn 45° view correlates with positive clinical outcomes after RHA. Level of Evidence III, Retrospective Comparative Study.

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Section: Discussionsupporting

confidence: 89%

Radiographic Factors Associated With Failure of Revision Hip Arthroscopy

Bloom¹,

Yu²,

Kingery³

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Nonoperative treatment for proximal AL tendon or AL/rectus abdominis aponeurosis injuries includes activity modification, compression shorts, physical therapy, physical modalities, manual therapy, medications, and injections, but these interventions frequently fail in the elite athlete. 13,15,24 The success of physical therapy with and without an active training program ranges from 11.7% to 78.6%, and corticosteroids may be helpful in 67% of athletes, although the data on the success of these nonoperative treatments are somewhat limited. 11,12,27 For those who fail nonoperative intervention, surgery typically results in favorable clinical outcomes.…”

mentioning

confidence: 99%

Ultrasound-Guided Cutting Wire Release of the Proximal Adductor Longus Tendon: A Feasibility Study

Boettcher

Hollman

Stuart

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background: Adductor longus tendinopathy is a well-known etiology of chronic groin pain in elite athletes. Surgery is indicated for those who fail conservative treatment. No studies to date have evaluated the feasibility of an ultrasound-guided release of the proximal adductor longus tendon. Purpose/Hypothesis: The primary aim of this study was to determine the feasibility of an ultrasound-guided selective adductor longus release with a cutting wire. A secondary aim was to determine safety by avoiding injury to adjacent structures. We hypothesized that the proximal adductor longus tendon can be released under ultrasound guidance with a cutting wire without injury to adjacent neurovascular or genitourinary structures. Study Design: Descriptive laboratory study. Methods: Ten adductor longus tendons (5 cadaveric specimens) from 4 males and 1 female between 76 and 89 years of age with a mean body mass index of 21.9 kg/m2 (range, 16.8-29.6 kg/m2) were used during this study. A single experienced physician sonographer performed ultrasound-guided proximal adductor longus tendon releases on all cadaveric specimens using a cutting wire. Dissection was performed by a second physician to determine the completeness of the tendon transections and to detect injury to adjacent neurovascular or genitourinary structures. Results: All 10 adductor longus tendons were transected. Eight of 10 transections were complete, whereas in 2 transections, >99% of the tendon was transected. There were no injuries to adjacent genitourinary or neurovascular structures. Conclusion: Ultrasound-guided adductor tendon release is feasible and safe in a cadaveric model. Further translational research should be performed to determine whether these results can be replicated in the clinical setting. Clinical Relevance: Adductor longus tendinopathy frequently requires surgical intervention and prolonged time away from sport. The present study suggests that a selective adductor longus tendon release can be performed with ultrasound guidance. This procedure warrants further translational research to explore its use in clinical practice.

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“…If CMI remains the most likely differential diagnosis following work-up, first-line treatment is non-operative for a minimum of 3–6 months [ 4 , 19 ]. This includes rest and activity modification, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and anaesthetic/corticosteroid or platelet-rich plasma (PRP) injections [ 4 , 13 , 20 ]. The focus of physical therapy in patients initiating non-operative management consists of maintaining pain and oedema control prior to developing coordination and strength of the hip adductors, flexors, internal rotators, extensors, core stabilizers and lumbopelvic spinal musculature [ 19 ].…”

Section: Non-operative Managementmentioning

confidence: 99%

A proposed algorithm for the treatment of core muscle injuries

Kraeutler

Mei-Dan

Castrodad

et al. 2021

Journal of Hip Preservation Surgery

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In recent years, there has been increased awareness and treatment of groin injuries in athletes. These injuries have been associated with various terminologies including sports hernia, core muscle injury (CMI), athletic pubalgia and inguinal disruption, among others. Treatment of these injuries has been performed by both orthopaedic and general surgeons and may include a variety of procedures such as rectus abdominis repair, adductor lengthening, abdominal wall repair with or without mesh, and hip arthroscopy for the treatment of concomitant femoroacetabular impingement. Despite our increased knowledge of these injuries, there is still no universal terminology, diagnostic methodology or treatment for a CMI. The purpose of this review is to present a detailed treatment algorithm for physicians treating patients with signs and symptoms of a CMI. In doing so, we aim to clarify the various pathologies involved in CMI, eliminate vague terminology, and present a clear, stepwise approach for both diagnosis and treatment of these injuries.

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The use of platelet-rich plasma to augment conservative and surgical treatment of hip and pelvic disorders

Cited by 28 publications

References 55 publications

Radiographic Factors Associated With Failure of Revision Hip Arthroscopy

Radiographic Factors Associated With Failure of Revision Hip Arthroscopy

Ultrasound-Guided Cutting Wire Release of the Proximal Adductor Longus Tendon: A Feasibility Study

A proposed algorithm for the treatment of core muscle injuries

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