Summary: We present indications for revision hip arthroscopy, incomplete cam resection remains the primary reason for revision followed by capsular complications and heterotopic ossification.

Background

Femoroacetabular impingement (FAI) has become an increasingly recognized diagnosis contributing to morbidity in the adolescent and young adult population over the past decade. Our ability to treat such pathology with hip arthroscopy has grown in parallel. As the number of hip arthroscopy cases performed annually continues to rise, so will the number of patients requiring revision surgery. Continuing to reassess trends in the indications for revision hip arthroscopy is critical to improve primary surgery techniques and accurately address pathology at the time of revision surgery. As such, the purpose of this study is to determine the trends in indications for revision hip arthroscopy.

Methods

A single-center hip preservation registry was reviewed to identify patients who underwent revision hip arthroscopy for the treatment of FAI between 2012 and 2019. Patient demographics and primary indications for revision hip arthroscopy were determined. Trends in the indications for revision hip arthroscopy were compared.

Results

A total of 229 patients met inclusion criteria for this study. Residual FAI in our cohort was the primary indication for revision with 68.1% of cases and remained the primary indication for revision in all years of the study. The second most common indication for revision was instability at 14.8%, third heterotopic ossification (HO) at 4.8% and fourth was adhesions at 3.9%. In cases in which instability was present, 39.4% were secondary to traumatic capsular deficiency, 34.2% were attributed to atraumatic capsular deficiency and 26.3% were attributed to borderline dysplasia. Numerous other findings were noted at the time of revision arthroscopy, 100% of patients were noted to have synovitis, in 97.8% loose osteochondral fragments were noted, 90.8% had labral tears, 47.6% had adhesions and 24.5% had heterotopic ossification.

Conclusion

The most common indication for revision hip arthroscopy in the treatment of femoroacetabular impingement remains residual impingement. However, capsular complications are increasingly recognized as an indication for revision hip arthroscopy highlighting the need for careful attention to capsular management, post-operative protection during the healing period, and preoperative recognition of hip instability. Lastly, heterotopic ossification is third most common reason for revision hip arthroscopy underlining the importance of postoperative prophylaxis.

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Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Not Every Hip Impingement Requires Hip Arthroscopy. Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Panagiota Vlaserou, BSc in Physiotherapy, MSc Biomedical Engineer, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Ioannis K. Antonopoulos, GREECE Vassilis N. Psychoyios, MD, GREECE Theodoros G. Troupis, Prof, GREECE
Covid Mortality Among Neck Of Femur Fractures During The Pandemic 2019 Abstract Presentation 5 minutes Aashish Raghu, MBBS, MS, MRCS, FRCS (Tr & Orth), UNITED KINGDOM Anas Hassan, MBBS, MRCS, UNITED KINGDOM Nicholas Dr Roeck, MB ChB, FRCS (ENG), FRCS (Tr&Orth), UNITED KINGDOM Mohamed Antar, MBBS, Master of Orthopaedics, MRCS, UNITED KINGDOM
Solving Social Inequality In Surgical Outcomes By Combining Standardized Treatment And Individualized Patient Education ePoster Presentation Benjamin Saks, MD, UNITED STATES Vivian Ouyang, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
The Surgeon Mentor Program: Outcomes of Total Hip Arthroplasty via the Direct Anterior Approach ePoster Presentation Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, AUSTRALIA Melinda Jiang, MD, AUSTRALIA Mark Inglis, FRACS BMBS B Med Sci FOrthoA, AUSTRALIA David Morris, MD, AUSTRALIA Nathan Eardley-Harris , MBBS, MClinSc, AUSTRALIA
Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Jennifer Kurowicki, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Edward Milman, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES
Comparison Of Pull-Out Strength Following Ligamentum Teres Reconstruction In The Hip: Peek Corkscrew Suture Anchor Versus Cortical Button Fixation: A Cadaveric Study. Abstract Presentation 5 minutes Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Can Hip Pain Be Treated With Tibial Malrotation Correction? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
What is the Association Between Anterior Cruciate Ligament Reconstruction and Femoroacetabular Impingement Surgery? An Analysis of Over 18,000 Hip Arthroscopies Abstract Presentation 6 minutes Clare Wise, BS , UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES Jeremy N. Truntzer, MD, UNITED STATES Robin Kamal, MD, MBA , UNITED STATES
Sex- And Age-Based Differences In Outcomes And Survivorship Following Primary Hip Arthroscopy At Short And Mid-Term Follow-Up: A Comparative Analysis ePoster Presentation David R. Maldonado, MD, UNITED STATES Jade S Owens, BS, UNITED STATES Cammille Go, BA, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Defining Sex-Based Outcomes Following Hip Arthroscopy In Patients With Borderline Hip Dysplasia. ePoster Presentation Benjamin Saks, MD, UNITED STATES James Fox, BBA, UNITED STATES Jade S Owens, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
Endoscopic Iliopsoas Lengthening For Treatment Of Recalcitrant Iliopsoas Tendinitis After Total Hip Arthroplasty Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES John Carlo Bonano, MD, UNITED STATES Christopher Jamero, MA, ATC, UNITED STATES Nicole Alexandria Segovia, BA, UNITED STATES James I. Huddleston, MD, UNITED STATES

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Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy

Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy

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Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy

Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy

Background

Methods

Results

Conclusion

More ISAKOS 2021: Global Content