Arthroscopic Hip Capsular Reconstruction Using Iliotibial Band Allograft as a Salvage Option for Unrepairable Capsular Defects Demonstrates Good Survivorship and Improved Patient-Reported Outcomes

Ruzbarsky, Joseph J.; Seiter, Max; Comfort, Spencer M.; Soares, Rui; Philippon, Marc J.

doi:10.1016/j.arthro.2021.12.035

Cited by 12 publications

(4 citation statements)

References 36 publications

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“…In the one study that performed capsular reconstruction the mean mHHS, HOS-SSS and HOS-ADL scores, all improved signiicantly postoperatively [32].…”

Section: Discussionmentioning

confidence: 96%

Hip microinstability diagnosis and management: a systematic review

Cohen

Jean

Patel

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of this systematic review is to present the most common causes, diagnostic features, treatment options and outcomes of patients with hip micro‐instability. MethodsThree online databases (MEDLINE, Embase, and PubMed) were searched from database inception March 2022, for literature addressing the diagnosis and management of patients with hip micro‐instability. Given the lack of consistent reporting of patient outcomes across studies, the results are presented in a descriptive summary fashion. ResultsOverall, there were a total of 9 studies including 189 patients (193 hips) included in this review of which 89% were female. All studies were level IV evidence with a mean MINORS score of 12 (range: 10–13). The most commonly used features for diagnosis of micro‐instability on history were anterior pain in 146 (78%) patients and a subjective feeling of instability with gait in 143 (81%) patients, while the most common feature on physical examination was the presence of anterior apprehension with combined hip extension and external rotation in 123 (65%) patients. The most common causes of micro‐instability were iatrogenic instability secondary to either capsular insufficiency or cam over‐resection in 76 (62%) patients and soft tissue laxity in 38 (31%) patients. ConclusionThe most common symptom of micro‐instability on history was anterior hip pain and on physical exam was pain with hip extension and external rotation. There are many treatment options and when managed appropriately based on the precise cause of micro‐instability, patients may demonstrate improved outcomes. Level of evidenceIV.

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“…In the one study that performed capsular reconstruction the mean mHHS, HOS-SSS and HOS-ADL scores, all improved signiicantly postoperatively [32].…”

Section: Discussionmentioning

confidence: 96%

Hip microinstability diagnosis and management: a systematic review

Cohen

Jean

Patel

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“… 27 has echoed those ex vivo biomechanical findings, showing postoperative improvement in clinical outcomes after hip capsular reconstruction at 2-year follow up. A wide array of graft and technical approaches have been described as options for reconstruction, including the use of dermal allograft 17 , 19 , 28 iliotibial band allograft, 29 , 30 Achilles allograft, 31 and bioinductive collagen implants, 32 among others.…”

Section: Discussionmentioning

confidence: 99%

Hip Capsular Reconstruction With Indirect Head of the Rectus Femoris Tendon

Mameri¹,

Batra²,

Kerzner³

et al. 2023

Arthroscopy Techniques

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“…Recently, Ruzbarsky et al. demonstrated a cohort of 39 patients with median 2 (range: 0–3) prior hip arthroscopy surgeries had a THA-free survival rate of 86% at 3 years following capsular reconstruction with 90% of patients achieving MCID for HOS-ADL and HOS-Sport at mean follow-up of 4.3 years [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

The revision hip arthroscopy complex: capsular deficiency, labral deficiency, femoral over-resection and adhesions can result in good survivorship with revision hip arthroscopy

Melugin,

Comfort,

Shelton

et al. 2023

Journal of Hip Preservation Surgery

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To evaluate the patient-reported outcomes (PROs) and survivorship of combined arthroscopic hip labral reconstruction/augmentation, capsular reconstruction, femoral neck remplissage and lysis of adhesions. Patients ≥18 years old who underwent this combination of procedures during revision hip arthroscopy and were eligible for minimum 2-year follow-up were identified. PRO scores including Hip Outcome Score (HOS)-Activities of Daily Living scale, HOS-Sports scale, modified Harris Hip Score, Short Form 12, and Western Ontario & McMaster Universities Osteoarthritis Index, patient satisfaction and failure rates were analyzed. Seven patients (5 females and 2 males) with average age of 45.0 ± 5.2 (range: 40–54 years) met inclusion criteria. Patients had a median of 1 (range: 1–3) prior hip surgery at an outside institution. All patients had previously undergone femoral osteoplasty, and 85% (6/7) of patients had a labral repair performed. Four patients had no capsule closure performed in their prior procedures. Six patients were available for minimum 2-year follow-up. Two patients converted to total hip arthroplasty: one patient with four prior hip arthroscopies and the other had advanced osteoarthritis with outerbridge grade 3/4 defects requiring microfracture. Mean patient satisfaction was 7 (range: 2–9). At mean follow-up of 3 years, most patients who underwent the combination of labral reconstruction, capsular reconstruction, femoral neck remplissage and lysis of adhesions during revision hip arthroscopy demonstrated improved PROs. This salvage procedure has the potential to restore hip function in patients who have failed an initial hip arthroscopy procedure. In patients with these pathologies present and concomitant joint space narrowing, a total hip arthroplasty may be a more appropriate salvage option.

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Arthroscopic Hip Capsular Reconstruction Using Iliotibial Band Allograft as a Salvage Option for Unrepairable Capsular Defects Demonstrates Good Survivorship and Improved Patient-Reported Outcomes

Cited by 12 publications

References 36 publications

Hip microinstability diagnosis and management: a systematic review

Hip microinstability diagnosis and management: a systematic review

Hip Capsular Reconstruction With Indirect Head of the Rectus Femoris Tendon

The revision hip arthroscopy complex: capsular deficiency, labral deficiency, femoral over-resection and adhesions can result in good survivorship with revision hip arthroscopy

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