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Background: Grading scales for adverse surgical outcomes have been poorly characterized to date. The primary aim of this study was to conduct a systematic review to enumerate the various frameworks for grading adverse postoperative outcomes; our secondary objective was to outline the properties of each grading system, identifying its strengths and weaknesses. Methods: We searched 9 databases (Africa Wide Information, Biosis, Cochrane, Embase, Global Health, LILACs, Medline, PubMed and Web of Science) from 1992 (the year the Clavien–Dindo classification system was developed) until Mar. 2, 2017, for studies that aimed to develop or improve on an already existing generalizable system for grading adverse postoperative outcomes. Study selection was duplicated as per PRISMA recommendations. Procedure-specific grading systems were excluded. We assessed the framework, strengths and weaknesses of the systems qualitatively. Results: We identified 9 studies on 8 adverse outcome grading systems with frameworks generalizable to any surgical procedure. Most systems have not been widely incorporated in the literature. Seven of the 8 systems were produced without including patients’ perspectives. Four allowed the derivation of a composite morbidity score, which had limited tangible significance for patients. Conclusion: Although each instrument identified offered its own advantages, none satisfied the need for a patient-centred tool capable of generating a composite score of all possible postoperative adverse outcomes (complications, sequelae and failure) that enables comparison of noninterventional and surgical management of disease. There is a need for development of a more comprehensive, patient-centred grading system for adverse postoperative outcomes.

Purpose Hip arthroscopy ofers a minimally invasive approach for the treatment of femoroacetabular impingement (FAI). Although osteoarthritis (OA) is a known negative prognostic factor for arthroscopy, it is unclear if patients with FAI and concomitant mild to moderate OA beneit from hip preservation surgery. The goal of this study was to evaluate current practice patterns among surgeons experienced in FAI management in the treatment of patients between 40 and 60 years of age with symptomatic FAI and concomitant OA of varying severity. Methods A 12-question cross-sectional survey was distributed using a secure electronic survey portal. The survey sought to determine surgical treatment of FAI in patients between the ages of 40 and 60 years old with concomitant OA of various degrees. Surveys were completed electronically and anonymously, with invitations distributed to members of the

Radiographic reporting in adolescent idiopathic scoliosis:Is there a discrepancy comparing radiologists' reports and surgeons' assessments? Karamjot Sidhu,

Purpose Within orthopaedic sports medicine, concomitant ligamentous laxity is often found to be a negative prognostic factor for post-operative outcomes following various procedures. The efect of ligamentous laxity on outcomes following hip arthroscopy remains infrequently reported. Therefore, the purpose of this study is to report on the outcomes of hip arthroscopy for the treatment of femoroacetabular impingement syndrome (FAIS) with concomitant generalized ligamentous laxity (GLL). Methods A systematic search was performed in Medline, EMBASE, CENTRAL, and SPORTDiscus (from inception to April 2021) for studies reporting outcomes following hip arthroscopy for symptomatic FAIS in patients with concomitant GLL. Results Six studies representing 213 patients and 231 hips were included. Outcomes of pain and functional scores as measured by VAS, Harris Hip Score, and Hip Disability and Osteoarthritis Outcomes Score were tabulated. A mean improvement of 4.8 on VAS was observed. Improvements of 30.0 on HHS, 33.1 for ssHOS, and 23.9 for ADL-HOS were observed. Conclusion Hip arthroscopy is an efective method of alleviating pain and improving function with statistically signiicant improvements in all PROM in patients with concomitant FAIS with GLL. Level of evidence IV. Prospero registration CRD42021248864. KeywordsArthroscopy • Hip arthroscopy • Femoroacetabular impingement • Joint instability • Joint laxity Abbreviations AA Alpha angle ADL Activities of daily living FAIS Femoroacetabular impingement syndrome GLL Generalized joint laxity HHS Harris hip score HOS Hip disability and osteoarthritis outcome score MCID Minimally clinical important diference MINORs Methodological index for non-randomized studies VAS Visual analogue scale * Moin Khan

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