Karadi H Sunil Kumar, Floris Van Damme, Ide Van den Borr, Vikas Khanduja, Emmanuel Audenaert, Ajay Malviya
{"title":"Understanding recurrent groin pain following periacetabular osteotomy: assessment of psoas tendon mechanics using discrete element analysis.","authors":"Karadi H Sunil Kumar, Floris Van Damme, Ide Van den Borr, Vikas Khanduja, Emmanuel Audenaert, Ajay Malviya","doi":"10.1093/jhps/hnae020","DOIUrl":"10.1093/jhps/hnae020","url":null,"abstract":"<p><p>Recurrent groin pain following periacetabular osteotomy (PAO) is a challenging problem. The purpose of our study was to evaluate the position and dynamics of the psoas tendon as a potential cause for recurrent groin pain following PAO. A total of 386 PAO procedures, performed between January 2013 and January 2020, were identified from a single surgeon series. Thirteen patients (18 hips) had a psoas tendinopathy, as confirmed with relief of symptoms following a diagnostic injection into the psoas tendon. All patients underwent computed tomography (CT) scans pre- and post-operatively. The data from CT scan was used to manually segment bony structures and create 3D models using Mimics software (Materialise NV). A validated discrete element analysis model using rigid body springs was used to predict psoas tendon movement during hip circumduction and walking. The distance of the iliopsoas tendon to any bony abnormality was calculated. All computational analyses were performed using MATLAB software. Thirteen hips (13/18) showed bony malformations (spurs, hypertrophic callus or delayed union and malunion) secondary to callus at the superior pubic ramus. The mean minimal distance of the iliopsoas tendon to osteotomy site was found to be 13.73 mm (<i>σ</i> = 3.09) for spurs, 10.99 mm (<i>σ</i> = 2.85) for hypertrophic callus and 11.91 mm (<i>σ</i> = 2.55) for canyon type. In normal bony healing, the mean minimal distance was 18.55 mm (<i>σ</i> = 4.11). Using a validated computational modelling technique, this study has demonstrated three different types of malformation around the superior pubic osteotomy site, which are associated with psoas impingement. In all of the cases, the minimal distance of the iliopsoas tendon to the osteotomy site was reduced by 59-74%, as compared with the normal anatomy.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 4","pages":"243-250"},"PeriodicalIF":1.4,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Spinal versus general anesthesia for hip arthroscopy-a pandemic (COVID) and epidemic (opioid) driven study.","authors":"","doi":"10.1093/jhps/hnae022","DOIUrl":"10.1093/jhps/hnae022","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/jhps/hnae009.].</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 3","pages":"232"},"PeriodicalIF":1.4,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Author response to 'Comparing analgesic effect of regional block after hip arthroscopy'.","authors":"Liangjing Yuan, Chengshi Xu, Ye Zhang, Geng Wang","doi":"10.1093/jhps/hnae007","DOIUrl":"10.1093/jhps/hnae007","url":null,"abstract":"","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 2","pages":"158"},"PeriodicalIF":1.4,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kenneth J Lukas, Reza Ojaghi, Kednapa Thavorn, Sasha Carsen, Kevin Smit, Paul E Beaulé
{"title":"Combined hip arthroscopy with periacetabular osteotomy for hip dysplasia: a systematic review","authors":"Kenneth J Lukas, Reza Ojaghi, Kednapa Thavorn, Sasha Carsen, Kevin Smit, Paul E Beaulé","doi":"10.1093/jhps/hnae016","DOIUrl":"https://doi.org/10.1093/jhps/hnae016","url":null,"abstract":"Periacetabular osteotomy (PAO) is a surgical procedure that corrects acetabular dysplasia without necessarily addressing intra-articular pathology. Hip arthroscopy is being increasingly used to address soft tissue pathologies at the time of a PAO. This review aims to determine patient-reported outcome measure scores (PROMs) of combining hip arthroscopy and PAO. This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify English studies that reported upon patient populations that had PAO’s performed with arthroscopy at the time of surgery for correcting developmental hip dysplasia. We identified 428 articles; 14 full-text articles met the inclusion criteria. Between 2011 and 2022, 1083 hips from the selected articles underwent a combined PAO and arthroscopic procedure, with a mean follow-up of 3.7 years. Of the studies that reported it, 63% of the evaluated population were found to have labral tears that required either labral repair (49%), labral debridement (12%) or combined procedure. Multiple PROMs were identified in the literature, with no standardized reporting system used between articles. All articles reported statistically improved patient-reported outcomes from a combined PAO and arthroscopy procedure. There was no difference in PROMs when comparing PAO performed with or without arthroscopy. One study suggested superior outcomes for active individuals who underwent PAO and arthroscopy. Patient-reported outcome scores improve significantly after PAO with or without arthroscopy, with no differences in adverse events, and only limited evidence that active individuals benefit from labral repair.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"101 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140628308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Josefin Abrahamson, Ida Lindman, Pall Jónasson, Yelverton Tegner
{"title":"High prevalence of former elite ice hockey players requiring early hip arthroplasty surgery","authors":"Josefin Abrahamson, Ida Lindman, Pall Jónasson, Yelverton Tegner","doi":"10.1093/jhps/hnae017","DOIUrl":"https://doi.org/10.1093/jhps/hnae017","url":null,"abstract":"The high-impact nature of ice hockey puts the players at a higher risk of developing early hip osteoarthritis (OA). This study aims to evaluate the presence of cam morphology, early radiological findings of OA and total hip arthroplasty (THA) in former Swedish elite ice hockey players. Male elite ice hockey players in the highest league in Sweden seeking orthopedic consultation for hip and groin pain with restricted hip joint range of motion and subsequent radiographs (Antero/posterior view, Lauenstein view and/or Hip frontal view) were included. The radiographs were performed between 1988 and 2009 and retrospectively examined for the presence of cam morphology (evaluated by α-angle ≥ 60°) and hip OA (evaluated by Tönnis classification). All players were contacted between 11 and 33 years after baseline radiograph examination for follow-up investigation of the presence of subsequent THA. A total of 44 male ice hockey players were included, of which 31 had available radiographs and 39 answered the follow-up questions. Cam morphology (α-angle ≥60°) was present in 81% of the players. Seven players (18%) had received a THA with a mean age of 55.7 (SD 6.1) years at time of THA-surgery. Tönnis score at baseline radiographs were associated with THA later in life (P &lt; 0.001). This study conclude that former elite Swedish ice hockey players underwent THA at a younger age than the general population. Despite confirming previous research of high prevalence of cam morphology in elite ice hockey players, no association could be established between cam morphology and the need for THA.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"3 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140628829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhuohua Lin, Ligang Cui, Yan Xu, Qiang Fu, Youjing Sun
{"title":"Feasibility and potential of intraoperative ultrasound in arthroscopy of femoroacetabular impingement.","authors":"Zhuohua Lin, Ligang Cui, Yan Xu, Qiang Fu, Youjing Sun","doi":"10.1093/jhps/hnad050","DOIUrl":"10.1093/jhps/hnad050","url":null,"abstract":"<p><p>This study aimed to evaluate the feasibility of using ultrasound for monitoring osteochondroplasty intraoperatively, determine the factors that interfere with ultrasound imaging and assess its influence on surgeon performance. Intraoperative ultrasonography was performed during osteochondroplasty in 39 cases of arthroscopy. The femoral head-neck junction (FHNJ) was evaluated using ultrasonography. Another 39 cases, which underwent conventional arthroscopy, were included in the control group. The C-arm was used in this group at the end of osteochondroplasty to confirm that no residual cam lesion remained. Pre- and postoperative Dunn radiographs and computed tomography (CT) scans were analyzed to determine the feasibility of ultrasound. Residual cam deformity was noted in eight cases under ultrasound. The FHNJ was not detected owing to ultrasound interference by air in three cases. No difference in the <i>α</i> angle measured in Dunn radiographs and the residual cam deformity rate of CT at the 1:00, 2:00 or 3:00 position was found between both groups. However, the <i>α</i> angle at the 3:00 position was greater in the ultrasound group than in the control group (44.4 ± 4.3° versus 41.3 ± 5.1°, <i>P</i> < 0.05), suggesting that more bone was preserved at 3:00 in the ultrasound group. No difference was found in the mean operation time. None of the patients experienced complications, such as wounds or intra-articular infections. Ultrasound is a safe method for assessing FHNJ during arthroscopy. It did not change the risk of residual cam deformity but positively affected the surgeon's performance by reducing unnecessary bone removal.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 3","pages":"204-209"},"PeriodicalIF":1.4,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"What the papers say.","authors":"Ali Bajwa","doi":"10.1093/jhps/hnae005","DOIUrl":"https://doi.org/10.1093/jhps/hnae005","url":null,"abstract":"","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 1","pages":"80-82"},"PeriodicalIF":1.5,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11005771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current trends for venous thromboembolic prophylaxis for hip arthroscopy: a modified Delphi and nominal group technique consensus study","authors":"Ali Parsa, Asheesh Bedi, Benjamin G Domb","doi":"10.1093/jhps/hnae014","DOIUrl":"https://doi.org/10.1093/jhps/hnae014","url":null,"abstract":"The overall risk of venous thromboembolism (VTE) after hip arthroscopy (HA) is reported to range from 0.2% to 9.5%, but a clear set of recommendations for VTE prophylaxis in HA patients remains scarce. The aim is to survey high-volume hip arthroscopists about their current trends regarding VTE prophylaxis use. A combination of two consensus group methods was used in this study: nominal group technique (NGT) and modified Delphi. A preliminary questionnaire was prepared, and rounds of discussion were completed between NGT members. The final version of the survey was administered to 35 high-volume hip surgeons. Delegates’ mean volume of annual hip arthroscopic surgery was 109. Approximately 22% of their patients are revision HA procedures. A total of 91.4% of delegates use chemoprophylaxis, 28.6% use sequential compression devices and 91.4% believed that chemoprophylaxis is necessary for more prolonged and complex procedures (strong consensus). Aspirin was the choice for all participants, and the duration was 2–3 weeks (31.4%), 1 month (65.7%) and 2–3 months (2.9%). History of VTE, hypercoagulable status, and malignancy were considered risk factors. No consensus was achieved for the discontinuation of oral contraceptive and smoking preoperatively. However, the optimal length of VTE prophylaxis is unclear. A total of 97.1% of the experts responded that they administer aspirin between 2 and 4 weeks. High-volume arthroscopic surgeons do consider VTE prophylaxis to be important and warranted in the postoperative setting. Aspirin is the mainstay of chemoprophylaxis, although the appropriate duration is unknown.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"1 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bjarne Mygind-Klavsen, Bent Lund, Torsten Grønbech Nielsen, Martin Lind
{"title":"Clinical outcomes after hip arthroscopy in acetabular dysplastic patients, previously treated with periacetabular osteotomy: a minimum of two-year follow-up data from the Danish Hip Arthroscopy Registry.","authors":"Bjarne Mygind-Klavsen, Bent Lund, Torsten Grønbech Nielsen, Martin Lind","doi":"10.1093/jhps/hnae015","DOIUrl":"10.1093/jhps/hnae015","url":null,"abstract":"<p><p>Periacetabular osteotomy (PAO) is the treatment of choice in dysplastic acetabulum. Due to continued symptoms, 2-11% of these patients require an additional hip arthroscopy. The purpose of this study was to report clinical outcome after a minimum of 2-year follow-up of additional hip arthroscopy after PAO with data from Danish Hip Arthroscopy Registry. Inclusion criteria in the study cohort were PAO surgery resulting in an additional hip arthroscopy procedure. The cohort was evaluated according to the surgical findings and patient-related outcome measures (PROMs) pre-operatively and at 2-year follow-up. A total of 287 patients were included in the study cohort. PROMs improved significantly in all subscales from pre-operatively to 2-year follow-up in the study cohort. According to PROM subscales, 47.8-57.6% and 25.2-38.2% achieved Minimal Clinical Important Difference and Patient Acceptable Symptom State, respectively. This study demonstrates, in PAO-treated patients, significant PROM improvements after additional hip arthroscopy. Unfortunately, only ∼50% and 30% achieved Minimal Clinical Important Difference and Patient Acceptable Symptom State, respectively.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"11 3","pages":"198-203"},"PeriodicalIF":1.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alistair Iw Mayne, Ahmed Saad, Rajesh Botchu, Lucie Gosling, Peter Wall, Angelos Politis, Peter D’Alessandro, Callum McBryde
{"title":"Quantifying radiation exposure in the radiological investigation of non-arthritic hip pain","authors":"Alistair Iw Mayne, Ahmed Saad, Rajesh Botchu, Lucie Gosling, Peter Wall, Angelos Politis, Peter D’Alessandro, Callum McBryde","doi":"10.1093/jhps/hnae013","DOIUrl":"https://doi.org/10.1093/jhps/hnae013","url":null,"abstract":"Radiological investigations are essential for evaluating underlying structural abnormalities in patients presenting with non-arthritic hip pain. The aim of this study is to quantify the radiation exposure associated with common radiological investigations performed in assessing patients presenting with non-arthritic hip pain. A retrospective review of our institutional imaging database was performed. Data were obtained for antero-posterior, cross-table lateral, frog lateral radiographs and low-dose CT hip protocol. The radiation dose of each imaging technique was measured in terms of dose-area product with units of mGy cm2, and the effective doses (ED, mSv) calculated. The effective radiation dose for each individual hip radiograph performed was in the range of 0.03–0.83 mSv [mean dose-area product 126.7–156.2 mGy cm2]. The mean ED associated with the low-dose CT hip protocol (including assessment of femoral anteversion and tibial torsion) was 3.04 mSv (416.8 mGy cm2). The radiation dose associated with the use of CT imaging was significantly greater than plain radiographs (P &lt; 0.005). Investigation of non-arthritic hip pain can lead to significant ionizing radiation exposure for patients. In our institution, the routine protocol is to obtain an antero-posterior pelvic radiograph and then a specific hip sequence Magnetic Resonance Imaging (MRI) scan which includes the assessment of femoral anteversion. This provides the necessary information in the majority of cases, with CT scanning reserved for more complex cases where we feel there is a specific indication. We would encourage the hip preservation community to carefully consider and review the use of ionizing radiation investigations.","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"77 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140579360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}