Revision Hip Arthroscopy: A Systematic Review of Diagnoses, Operative Findings, and Outcomes

Cvetanovich, Gregory L.; Harris, Joshua D.; Erickson, Brandon J.; Bach, Bernard R.; Bush‐Joseph, Charles A.; Nho, Shane J.

doi:10.1016/j.arthro.2014.12.027

Cited by 142 publications

(126 citation statements)

References 39 publications

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“…Although 3D imaging can identify larger α°than 2D imaging, these differences are mainly the result of measurement location [19]. Furthermore, there is an increased risk of residual impingement and vascular insult resulting from surgical treatment based on inaccurate data regarding the extent of deformities [27,28,51]. Intervals for the α°were significantly different between genders, coherent with results reported by Hack et al [35] but divergent from other studies [25,30] (Table 7).…”

Section: Discussioncontrasting

confidence: 38%

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Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

et al. 2016

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Objective Our objectives were to use 3D computed tomography (CT) to define head-neck morphologic gender-specific and normative parameters in asymptomatic individuals and use the omega angle (Ω°) to provide quantification data on the location and radial extension of a cam deformity. Methods We prospectively included 350 individuals and evaluated 188 asymptomatic hips that underwent semiautomated CT analysis. Different thresholds of alpha angle (α°) were considered in order to analyze cam morphology and determine Ω°. We calculated overall and gender-specific parameters for imaging signs of cam morphology (Ω°and circumferential α°). Results The 95 % reference interval limits were beyond abnormal thresholds found in the literature for cam morphology. Specifically, α°at 3/1 o´clock were 46.9°/60.8°overall, 51.8°/ 65.4°for men and 45.7°/55.3°for women. Cam prevalence, magnitude, location, and epicenter were significantly gender different. Increasing α°correlated with higher Ω°, meaning that higher angles correspond to larger cam deformities.Conclusion Hip morphometry measurements in this cohort of asymptomatic individuals extended beyond current thresholds used for the clinical diagnosis of cam deformity, and α°was found to vary both by gender and measurement location. These results suggest that α°measurement is insufficient for the diagnosis of cam deformity. Enhanced morphometric evaluation, including 3D imaging and Ω°, may enable a more accurate diagnosis. Key Points • 95% reference interval limits of cam morphotype were beyond currently defined thresholds.• Current morphometric definitions for cam-type morphotype should be applied with care.• Cam prevalence, magnitude, location, and epicenter are significantly gender different.• Cam and alpha angle thresholds should be defined according to sex/location. • Quantitative 3D morphometric assessment allows thorough and reproducible FAI diagnosis and monitoring.

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Section: Discussioncontrasting

confidence: 38%

“…In addition, we lack normative data with regard to 3D morphology of the FHN in asymptomatic individuals. A predictable and accurate method for evaluating femoral morphology is needed to optimize surgical results and minimize complications [28].…”

Section: Introductionmentioning

confidence: 99%

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

et al. 2016

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“…With adequate training, arthroscopic osseous correction [ 3,6,16 ] as well as treatment of labral and chondral damages [ 34,37 ] in standard FAI affecting the anterior aspect of the joint can now be performed comparably to open surgery [ 27 ]. Most reports on clinical or radiographic results after arthroscopic treatment of FAI are however limited by short-term followup [ 12,25 ] and thus the success or failure of these procedures over time is not known.…”

Section: Introductionmentioning

confidence: 99%

What Are the Risk Factors for Revision Surgery After Hip Arthroscopy for Femoroacetabular Impingement at 7-year Followup?

Haefeli

Albers

Steppacher

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…With the increasing number of primary hip arthroscopies being performed, surgeons are increasingly facing with patients with recurrent or persistent pain, and with the need of a revision surgery. Recent studies reported a revision rate after hip arthroscopy from 1.9 to 7.7%, with a mean interval between the first arthroscopy and revision surgery of 25 months 20,21 . The most common cause for revision hip arthroscopy are residual FAI (from 68% to 81% of cases), labral pathology or reruptures (53%), cartilage injuries (36%), adhesions (24%), ligamentum teres pathology (15%), iliopsoas tendon pathology (13%) and loose bodies (6%) 21,22 .…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies reported a revision rate after hip arthroscopy from 1.9 to 7.7%, with a mean interval between the first arthroscopy and revision surgery of 25 months 20,21 . The most common cause for revision hip arthroscopy are residual FAI (from 68% to 81% of cases), labral pathology or reruptures (53%), cartilage injuries (36%), adhesions (24%), ligamentum teres pathology (15%), iliopsoas tendon pathology (13%) and loose bodies (6%) 21,22 . Gupta et al recently reported that in 20% of patients who had a revision hip arthroscopy surgery an internal snapping hip was objectivated at the preoperative physical examination, and that an iliopsoas tendon release was performed in 37% of all patients 23 .…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic release of iliopsoas tendon in patients with femoro-acetabular impingement: clinical results at mid-term follow-up

Mardones

Via

Tomic

et al. 2016

MLTJ

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SummaryBackground: The iliopsoas tendon is a recognized cause of extra-articular hip pain, and tenotomy has been described as an effective treatment in patients who do not respond to conservative treatments. Endoscopic release showed higher success rate, lower recurrence, fewer complications compared to open surgery. The aim of the study is to report the results at a mean of 4 years follow-up of a series of patients affected by femoroacetabular impingement (FAI) and an associated iliopsoas tendinopathy, treated with hip arthroscopy and transcapsular tendon release. Methods: Fifteen patients were retrospectively reviewed. Assessment of radiographic signs of FAI was performed, the alpha angle, the femoral headneck offset and the lateral center edge angle (LCEA) were collected. Osteoarthritis was assessed from the AP pelvic and graded according to the Tönnis classification. Modified Harris Hip Score (mHHS), VAIL score and VAS score were administered to all patients before surgery, at follow-up at 1 year (T1) and final follow-up (T2). Results: We found a statistical significant improvement in functional scores (mHHS and VAIL score) from the baseline to T2. According to VAS score, a statistical significant improvement was also found from T0 to T2, from a median of 5.5 (range 3-7) to 0 (range 0-5) (P<0.001). Two patients referred a recurrence of pain one year after surgery who were treated conservatively. No other complications have been reported. Conclusion: Iliopsoas tendinopathy can be associated to FAI in some patients, and failure in diagnosing and treating may be the reason of poor results and a revision surgery. Arthroscopic iliopsoas tendon release seems to produce good clinical outcome, reducing pain and the rate of a revision surgeries. Level of evidence: IV case series. KEY WORDS: hip arthroscopy, femoroacetabular impingement, iliopsoas tendon, tendinopathy, arthroscopic tendon release.

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Revision Hip Arthroscopy: A Systematic Review of Diagnoses, Operative Findings, and Outcomes

Cited by 142 publications

References 39 publications

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

What Are the Risk Factors for Revision Surgery After Hip Arthroscopy for Femoroacetabular Impingement at 7-year Followup?

Arthroscopic release of iliopsoas tendon in patients with femoro-acetabular impingement: clinical results at mid-term follow-up

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