Current Concepts in Hip Preservation Surgery

Abstract

Context:Successful treatment of nonarthritic hip pain in young athletic individuals remains a challenge. A growing fund of clinical knowledge has paralleled technical innovations that have enabled hip preservation surgeons to address a multitude of structural variations of the proximal femur and acetabulum and concomitant intra-articular joint pathology. Often, a combination of open and arthroscopic techniques are necessary to treat more complex pathomorphologies. Peri- and postoperative recovery after such procedures can pose a substantial challenge to the patient, and a dedicated, thoughtful approach may reduce setbacks, limit morbidity, and help optimize functional outcomes.Evidence Acquisition:PubMed and CINAHL databases were searched to identify relevant scientific and review articles through December 2014 using the search terms hip preservation, labrum, surgical dislocation, femoroacetabular impingement, postoperative rehabilitation, peri-acetabular osteotomy, and rotational osteotomy. Reference lists of included articles were reviewed to locate additional references of interest.Study Design:Clinical review.Level of Evidence:Level 4.Results:Hip preservation procedures and appropriate rehabilitation have allowed individuals to return to a physically active lifestyle.Conclusion:Effective postoperative rehabilitation must consider modifications and precautions specific to the particular surgical techniques used. Proper postoperative rehabilitation after hip preservation surgery may help optimize functional recovery and maximize clinical success and patient satisfaction.

Postoperative Weightbearing Protocols After Arthroscopic Surgery for Femoroacetabular Impingement Does Not Affect Patient Outcome: A Comparative Study With Minimum 2-Year Follow-up

“…The change in the the mHHS was 21.9 (17-27) for the NWB group and 19.0 (11-25) for the WBAT group (P ¼ .482). The change in the HOS was 17.5 (13-23) for the NWB group and 26.5 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) for the WBAT group (P ¼ .082). The rate of patients who met or exceeded the MCID for the mHHS was 82.6% in the NWB group and 81.2% in the WBAT group (P ¼ .0.838), and for the HOS, the rate was 79.7% in the NWB group and 82.8% in the WBAT group (P ¼ .647).…”

“…Because there are currently no conclusive data or previous literature with substantial evidence regarding postoperative rehabilitation protocols after arthroscopic labral repairs, such protocols are determined by the treating surgeon. 8,16 A general survey of hip arthroscopy surgeons suggests that most surgeons prefer to prescribe immediate WBAT after arthroscopic labral repairs. 7 Cvetanovich et al 1 conducted a survey to assess the comprehensiveness and variability of online postoperative physical therapy protocols regarding hip arthroscopy for FAI and/or labral repairs.…”

Rehabilitación del Atrapamiento Femoroacetabular tras Artroscopia: revisión sistemática y propuesta de programa contextualizado

“…Sin embargo, sí encontramos muchas revisiones narrativas y comentarios clínicos que exponen orientaciones para estructurar los programas RAFA. Estos artículos son muy heterogéneos, con una variabilidad considerable en cuanto a restricciones postoperatorias, contenidos y periodización de los programas [26][27][28][29][30][31][32] . Los protocolos que exponen no han sido validados, pero son de gran utilidad para el diseño de programas de rehabilitación evolucionados que puedan ser objeto de futuros ensayos clínicos, como el que proponemos en el siguiente apartado y desarrollamos en los anexos.…”

“…En la primera fase, suponiendo que el paciente no va a contar con una máquina de movilización pasiva continua 18,23,27,28,33 , hemos programado ejercicios de movilización temprana a realizar por un fisioterapeuta y autoasistidos, como rotaciones pasivas en silla giratoria y bicicleta sin resistencia 20,23,25,[27][28][29][30][31][32][33] . No obstante, durante las movilizaciones no se debe forzar la amplitud si se siente pellizcamiento en la cadera 28,30 .…”

Contribution of Surgical Procedures Including Insertions of Implants, Stents, and Pacemakers to Longevity

“…Today surgeries are performed in outpatient clinics and in hospitals requiring stays ranging from few hours to overnight stay and at times several days stay [3,4]. There are several different types of surgeries performed in this century [5] ranging from tonsillectomy, appendectomies to cardiac bypass surgeries [6][7][8][9], transplantation [10][11][12], removal of benign and malignant tumors, gall stone and kidney stone removals, hip, and knee replacements [13][14][15][16], bariatric and metabolic surgery [17], cataract removal and lens insertion, insertion of implants, stents [9], pacemakers etc. All these surgeries done either due to emergencies or elective (prescheduled) potentially extend life significantly.…”