Capsulolabral Adhesions After Hip Arthroscopy for the Treatment of Femoroacetabular Impingement: Strategies During Rehabilitation and Return to Sport to Reduce the Risk of Revision

Abstract

This article will review various strategies such as passive range of motion modalities, active range of motion movements, and pharmacological interventions for the prevention of adhesion formation after hip arthroscopy. Capsulolabral adhesions are a common cause of revision hip arthroscopy for which treatment methods are still evolving. Efforts to prevent and limit their formation postoperatively, including adjuncts such as losartan, as well as the use of consistent passive and active, multiplanar movements, both therapist and continuous passive motion machine assisted, should be considered.

Arthroscopic Femoral Head Allograft With Proximal Femoral/Periacetabular Osteotomies for Sequelae of Perthes

“…The authors reported good outcomes in the majority of patients, without any conversions to arthroplasty, lending support for our surgical approach. However, a less invasive technique for bone grafting is preferable in the setting of acetabular and/or femoral osteotomy to facilitate rehabilitation 18,21,22 .…”

“…In another study, Clohisy et al 12 used an anterior arthrotomy with simultaneous PAO and DFO in young adults with severe hip disease. However, anterior arthrotomy leads to prolonged surgical times when performed with PAO, complicates PAO recovery due to excessive adhesions, and is inferior to arthroscopy for intra-articular work 18,21,22 . Furthermore, Ko et al 23 detailed the utilization of a “trap door” bone grafting technique with a concomitant acetabular and/or femoral osteotomy to treat 9 adolescents with femoral head osteonecrosis and collapse of the articular surface.…”

“…Arthroscopic management of femoral head OCD lesions offers multiple advantages, including decreased surgical complication risk, reduced postoperative adhesions, avoiding open arthrotomy, and a smaller incision size 18-20 . Furthermore, before PAO and/or DFO, arthroscopy has been shown superior to open arthrotomy for intra-articular work 21,22 .…”

Limited clinical utility of a machine learning revision prediction model based on a national hip arthroscopy registry

“…Over the last two decades, hip arthroscopy has been increasingly performed for the treatment of this intra-articular hip disorder along with cartilage and labral injuries [ 4 , 7 , 42 ]. As the annual number of procedures has increased, many studies have sought to evaluate the risk of undergoing a subsequent revision hip arthroscopy [ 1 , 2 , 5 , 6 , 9 , 11 , 12 , 14 , 17 , 23 , 28 , 32 , 34 , 38 ]. Though these studies have identified several risk factors associated with revision surgery, the ability to translate these pre-operative factors into a specific risk score is poor.…”