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Coulomb R, Nougarede B, Maury E, Marchand P, Mares O, Kouyoumdjian P. Arthroscopic iliopsoas tenotomies: a systematic review of surgical technique and outcomes. Hip Int 2022; 32:4-11. [PMID: 33226846 DOI: 10.1177/1120700020970519] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the technique, results and complications of arthroscopic iliopsoas tenotomies either on native hips or total hip arthroplasty (THA). METHODS A systematic review was performed using 3 databases: PubMed, EMBASE and the Cochrane library from January 2000 to December 2018 in accordance with the PRISMA procedure. The literature search, data extraction and quality assessment were conducted by 2 independent reviewers. Surgical technique, clinical outcomes, recurrences and complication rate were evaluated. RESULTS Out of 115 articles reviewed, 20 articles concerned native hips and 8 articles THA. 3 levels of release were described. For native hips, the recurrence rate was higher for central compartment than peripheral or lesser trochanter releases. Complication rates were similar for hip arthroscopy but remained low in all series. Loss of strength was evaluated mainly using the MRC muscle scale. Most studies noted strength recovery. MRI analysis of muscle atrophy was greater for lesser trochanter than for central compartment release but unrelated to loss of strength. The complication rate was low for tenotomy after THA, heterotopic ossification being the most common complication. CONCLUSIONS Central compartment releases lead to the highest rate of recurrence due to incomplete release. Peripheral releases have a potential risk of vascular injury. The lesser trochanteric approach has the disadvantage of not having direct access to the joint. The main difficulty with THA lies in the diagnosis of cup/iliopsoas impingement. Diagnostic tests with infiltration should be made before iliopsoas release to prevent its failure. Cup protrusion of over 8mm is a potential indication for acetabular revision.
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Affiliation(s)
- Remy Coulomb
- Nîmes University Hospital (CHU Nimes), Nîmes, France
| | | | - Etienne Maury
- Nîmes University Hospital (CHU Nimes), Nîmes, France
| | | | - Olivier Mares
- Nîmes University Hospital (CHU Nimes), Nîmes, France
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2
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Zimmerer A, Hauschild M, Nietschke R, Schneider MM, Wassilew G, Sobau C, Miehlke W. Results after arthroscopic treatment of iliopsoas impingement after total hip arthroplasty. Arch Orthop Trauma Surg 2022; 142:189-195. [PMID: 33044706 PMCID: PMC8783918 DOI: 10.1007/s00402-020-03623-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/30/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND A cause of groin pain after total hip arthroplasty (THA) is mechanical irritation or impingement of the iliopsoas tendon. The incidence is about 4%. If conservative therapy fails, an arthroscopic release of the iliopsoas tendon can be performed. The aim of the study was to assess the mid-term clinical outcome after arthroscopic release. We hypothesize that good results can be achieved by a minimally invasive endoscopic procedure. METHODS Using our in-house database, all patients who received an endoscopic release of the iliopsoas tendon due to mechanical irritation after THA were identified. Inclusion criteria were mechanical irritation of the iliopsoas tendon after cementless THA with minimal acetabular component prominence. Exclusion criteria were marked prominence of the acetabular component and groin pain after THA for any other reason. In these patients, the modified Harris Hip Score (mHHS), the pain level using the numerical analogue scale and the UCLA Activity Score were measured. The mean follow-up period was 7 ± 3.8 (2.6-11.7) years. RESULTS 25 patients were identified in whom an arthroscopic release of the iliopsoas tendon had been performed since 2007. The data of 20 patients were available at follow-up. The gender ratio was 1:1, the average age at the time of arthroscopy was 59 ± 27.7 (52-78) years. The average interval between THA and arthroscopy was 6.3 ± 4.0 (1.7-15) years. The mHHS showed a significant improvement from preoperative 31.2 ± 9.8 (17.6-47.3) to 82.0 ± 9.8 (46.2-100) points (p = 0.001). The pain level on the NAS decreased significantly from 8.5 ± 1.2 (7-10) to 2.5 ± 1.8 (0-6) points (p = 0.001). The activity level based on the UCLA Activity Score raised from 4.0 ± 2.7 (0-7) to 6.5 ± 1.8 (3-9) (p = 0.09). CONCLUSION Mechanical irritation and impingement of the iliopsoas tendon is an important diagnosis to be considered in persistent groin pain after total hip arthroplasty. In failure of non-operative treatment, good clinical results can be achieved with arthroscopic release and the pain level can be significantly reduced. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- A Zimmerer
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179, Pforzheim, Germany.
- Department of Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
| | - M Hauschild
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179, Pforzheim, Germany
| | - R Nietschke
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179, Pforzheim, Germany
| | - M M Schneider
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179, Pforzheim, Germany
- University of Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - G Wassilew
- Department of Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - C Sobau
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179, Pforzheim, Germany
| | - W Miehlke
- ARCUS Sportklinik, Rastatterstr. 17-19, 75179, Pforzheim, Germany
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3
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Audenaert EA, Khanduja V, Claes P, Malviya A, Steenackers G. Mechanics of Psoas Tendon Snapping. A Virtual Population Study. Front Bioeng Biotechnol 2020; 8:264. [PMID: 32292780 PMCID: PMC7118580 DOI: 10.3389/fbioe.2020.00264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/13/2020] [Indexed: 12/24/2022] Open
Abstract
Internal snapping of the psoas tendon is a frequently reported condition, especially in young adolescents involved in sports. It is defined as an increased tendon excursion over bony or soft tissue prominence causing local irritation and inflammation of the tendon leading to groin pain and often is accompanied by an audible snap. Due to the lack of detailed dynamic visualization means, the exact mechanism of the condition remains poorly understood and different theories have been postulated related to the etiology and its location about the hip. In the present study we simulated psoas tendon behavior in a virtual population of 40,000 anatomies and compared tendon movement during combined abduction, flexion and external rotation and back to neutral extension and adduction. At risk phenotyopes for tendon snapping were defined as the morphologies presenting with excess tendon movement. There were little differences in tendon movement between the male and female models. In both populations, abnormal tendon excursion correlated with changes in mainly the femoral anatomy (male r = 0.72, p < 0.001, female r = 0.66, p < 0.001): increased anteversion and valgus as well as a decreasing femoral offset and ischiofemoral distance. The observed combination of shape components correlating with excess tendon movement in essence presented with a medial positioning of the minor trochanter. This finding suggest that psoas snapping and ischiofemoral impingement are possibly two presentations of a similar underlying rotational dysplasia of the femur.
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Affiliation(s)
- Emmanuel A Audenaert
- Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom.,Op3Mech Research Group, Department of Electromechanics, University of Antwerp, Antwerp, Belgium.,Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Vikas Khanduja
- Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom
| | - Peter Claes
- Medical Imaging Research Center (MIRC), University Hospitals Leuven, Leuven, Belgium.,Department of Electrical Engineering/Processing Speech and Images, KU Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven, Leuven, Belgium.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Ajay Malviya
- Department of Orthopedic Surgery and Traumatology, Northumbria National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom.,Department of Regenerative Medicine, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gunther Steenackers
- Op3Mech Research Group, Department of Electromechanics, University of Antwerp, Antwerp, Belgium
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4
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Pohlig F, Mühlhofer HML, Lenze U, Lenze FW, Suren C, Harrasser N, von Eisenhart-Rothe R, Schauwecker J. Diagnostic accuracy of arthroscopic biopsy in periprosthetic infections of the hip. Eur J Med Res 2017; 22:6. [PMID: 28259167 PMCID: PMC5336685 DOI: 10.1186/s40001-017-0246-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 02/28/2017] [Indexed: 01/26/2023] Open
Abstract
Background Diagnosis of a low-grade periprosthetic joint infection (PJI) prior to revision surgery can be challenging, despite paramount importance for further treatment. Arthroscopic biopsy of synovial and periprosthetic tissue with subsequent microbiological and histological examination can be beneficial but its specific diagnostic value has not been clearly defined. Methods 20 consecutive patients who underwent percutaneous synovial fluid aspiration as well as arthroscopic biopsy due to suspected PJI of the hip and subsequent one- or two-stage revision surgery at our institution between January 2012 and May 2015 were enrolled. Indication was based on the criteria (1) history of PJI and increased levels of erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), (2) suspicious cell count and differential but negative bacterial culture in synovial aspirate, (3) early loosening (<less than 2 years), or (4) persisting pain without loosening but history of a PJI. At least two criteria had to be fulfilled in order to perform an arthroscopic biopsy. Results Best overall diagnostic value was identified for arthroscopic biopsy and a combination of bacteriological and histological analysis with a sensitivity of 87.5%, specificity of 100% and accuracy of 95%. Bacteriological assessment of synovial aspirate revealed a sensitivity of 50.0%, specificity of 91.7%, and accuracy of 75%. ESR and CRP yielded a sensitivity of 75.0% for either hematologic test and specificities of 87.5 and 66.7%, respectively. Conclusions In conclusion, our data indicate that arthroscopic biopsy is superior to ESR and CRP as well as joint aspiration and their combinations. Concurrent microbiological and histological examination of the biopsy specimens allows for identification of the causative pathogen and its susceptibility pattern in order to preoperatively plan the surgical strategy as well as the antibiotic regimen. Moreover, intraarticular mechanical failure can be detected during hip arthroscopy emphasizing its diagnostic value. Level II diagnostic study.
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Affiliation(s)
- Florian Pohlig
- Department of Orthopedic Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Heinrich M L Mühlhofer
- Department of Orthopedic Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Ulrich Lenze
- Department of Orthopedic Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian W Lenze
- Department of Traumatology, Klinikum Traunstein, Cuno-Niggl-Str. 3, 83278, Traunstein, Germany
| | - Christian Suren
- Department of Orthopedic Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Norbert Harrasser
- Department of Orthopedic Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Rüdiger von Eisenhart-Rothe
- Department of Orthopedic Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Johannes Schauwecker
- Department of Orthopedic Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany
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5
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The role of arthroscopy in the treatment of groin pain after total hip arthroplasty: our experience. Hip Int 2016; 26 Suppl 1:28-33. [PMID: 27174071 DOI: 10.5301/hipint.5000405] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 02/04/2023]
Abstract
AIM The purpose of the study was to present our arthroscopic surgical technique and the results in patient with pain after a hip replacement. METHODS Between November 2009 and September 2011, 35 patients with groin pain after total hip arthroplasty (THA) were treated arthroscopically. The patients underwent a preoperative examination consisting in careful history, physical examination, laboratory evaluation, diagnostic evaluation using x-rays and pelvis CT scans. In patients for whom the clinical picture suggested iliopsoas tendonitis, we also performed injection of local anaesthetic on the iliopsoas tendon sheath. All the patients were positioned in the supine decubitus position with traction applied, using 2 arthroscopic portals (AL, MID-A). An extensive debridement of adhesions, periprosthetic tissue and neocapsula were performed; when there were signs of iliopsoas impingement, a transcapsular tenotomy was performed according to Wettstein technique. RESULTS The average age was 57 (29-77) years old. The average time to onset of symptoms was 10.8 (5-15) months after THA. The average preoperative Harris Hip Score (HHS) was 44.1 (range 32-56). The average preoperative Medical Research Council (MRC) scale for muscle strenght was 3.27 (range 3-4). After 24 months of follow-up patients show an average HHS of 75.73 (range 50-91). Patients who underwent iliopsoas release show a postoperative HHS of 83.28 (range 61-91). The average postoperative MRC scale was 4.45. CONCLUSIONS Hip arthroscopy in treatment of reactive synovitis and adhesions shows good results according to literature. Hip arthroscopy in treatment of anterior iliopsoas impingement is the most useful instrument, being less invasive than the classic open technique.
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6
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The Role of Hip Arthroscopy in Investigating and Managing the Painful Hip Resurfacing Arthroplasty. Arthroscopy 2016; 32:459-466.e1. [PMID: 26553962 DOI: 10.1016/j.arthro.2015.08.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 07/20/2015] [Accepted: 08/11/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the safety and efficacy of hip arthroscopy performed in the peripheral compartment as a diagnostic and therapeutic treatment option for patients with hip pain after hip resurfacing surgery. METHODS Indications for hip arthroscopy after hip resurfacing included patients with a symptomatic hip-resurfaced arthroplasties who did not respond to nonoperative treatment. Patients who underwent a hip arthroscopy after a painful hip resurfacing were included with a minimum of 1 year follow-up. Subgroup analysis was performed according to whether an established diagnosis was made before arthroscopic intervention or not. Subjective measures were based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, and results were calculated and analyzed. RESULTS We included 68 patients (26 male [38%] and 42 female [62%]) who underwent subsequent hip arthroscopy from a population of 978 consecutive hip-resurfaced arthroplasties performed between 1999 and 2010. The average age was 58 (range, 37 to 78 years). The mean follow-up after hip arthroscopy was 3.4 years (range, 12 months to 5.8 years). Patients who had an established diagnosis (n = 41) before hip arthroscopy showed statistical improvement in their WOMAC scores (7 to 2, P < .001). Only 3 (7%) of these 41 patients failed and were converted to a total hip replacement (THR); however, patients who did not have an established diagnosis (n = 27) before undergoing hip arthroscopy showed statistical worsening of the WOMAC (15 to 21, P = .002). Ten (37%) of these 27 patients without a diagnosis failed and needed to be converted to a THR. A significant correlation was found between the collections found on ultrasound (psoas bursa and/or in the hip joint) and the need for synovectomy (P = .01). The overall revision rate to THR after hip resurfacing in our group of patients was 1.3% (n = 13). Female patients were more likely to require postresurfacing hip arthroscopy with 42 (60%) female to only 26 (40%) male patients undergoing this procedure. In our study population, 70% (14/21, P < .05) of patients with hip pain caused by severe metal synovial reaction or metal-on-metal reaction were women. A total of 5 (7%) patients had minor-to-mild complications after hip arthroscopy. CONCLUSIONS Hip arthroscopy is a safe surgical treatment option for those patients with a painful hip resurfacing arthroplasty. Having an accurate diagnosis before hip arthroscopy improves the likelihood a good outcome. LEVEL OF EVIDENCE Level IV - therapeutic case series.
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7
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Heaven S, de Sa D, Simunovic N, Williams DS, Naudie D, Ayeni OR. Hip arthroscopy in the setting of hip arthroplasty. Knee Surg Sports Traumatol Arthrosc 2016; 24:287-94. [PMID: 25410060 DOI: 10.1007/s00167-014-3379-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/07/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE Hip arthroscopy has traditionally been viewed as a hip preservation procedure performed in patients with native joint pathology. However, as the list of indications for arthroscopic hip intervention grows, further advances are expanding its use. The purpose of this systematic review was to examine existing evidence supporting the use of hip arthroscopy in the setting of hip arthroplasty. METHODS Using predetermined inclusion criteria, EMBASE, MEDLINE and PubMed were searched for articles addressing arthroscopic hip surgery performed in hips containing joint replacement arthroplasties. Inclusion criteria limited our search to human and English language studies addressing articles where clear surgical indications are described. Article screening was conducted in duplicate. RESULTS Seven-hundred and forty-three studies were retrieved before duplicate screening, and 18 satisfied inclusion criteria. Eleven case series, six case reports and one prospective cohort study are included. In total, 171 patients underwent hip arthroscopy following previous arthroplasty. Indications for arthroscopy included iliopsoas tendinopathy (35.8%), symptomatic hips with no clear diagnosis despite extensive investigation (24.6%), periprosthetic infection (6.4%) and intra-articular loose bodies (3.5%). Almost all patients who underwent hip arthroscopy experienced positive outcomes from the procedure. CONCLUSION Hip arthroscopy after hip arthroplasty is supported by our systematic review for a variety of indications. Hip arthroscopy can be a safe and effective method of treating hip arthroplasty patients with iliopsoas tendinopathy. Hip arthroscopy also has utility in patients with symptomatic hip arthroplasty despite exhaustion of other diagnostic avenues. LEVEL OF EVIDENCE A systematic review of level IV studies.
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Affiliation(s)
- S Heaven
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada
| | - Darren de Sa
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada
| | - N Simunovic
- Centre for Evidence Based Orthopaedics, Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - D S Williams
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada
| | - D Naudie
- Division of Orthopaedic Surgery, London Health Sciences Centre-University Hospital, 339 Windermere Road, London, ON, N6A 5A5, Canada
| | - O R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
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8
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Arthroscopic treatment for acute septic arthritis of the hip joint in adults. Knee Surg Sports Traumatol Arthrosc 2014; 22:942-5. [PMID: 23114869 DOI: 10.1007/s00167-012-2283-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 10/23/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The purpose of our study was to evaluate the efficacy and safety of the arthroscopic management of septic arthritis of the hip joint. METHODS From October 2009 to October 2010, nine patients with septic arthritis of the hip were treated with arthroscopic debridement and drainage and systemic antibiotics according to bacterial sensitivity or with empiric antibiotics if no bacteria was isolated from the cultures. All patients were placed in the supine position on a fracture table, and two or three arthroscopic portals were used. The medical records were retrospectively reviewed to determine the efficacy and safety of hip arthroscopy for septic arthritis. RESULTS There were 4 men and 5 women, with a mean age of 49.8 years (SD 12.1). No major complication related to arthroscopy of the hip was encountered. Staphylococcus aureus was identified in 4 patients. Average follow-up was 19.4 months (SD 4.1). Septic arthritis relapsed in one patient, but the other 8 patients experienced no recurrence during the follow-up period. CONCLUSIONS Arthroscopic lavage and debridement is a safe and effective procedure for septic arthritis of the hip joint.
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Polesello GC, Pereira Guimarães R, Ricioli Júnior W, Keiske Ono N, Kiyoshi Honda E, Cavalheiro de Queiroz M. Current possibilities for hip arthroplasty. Rev Bras Ortop 2014; 49:103-10. [PMID: 26229784 PMCID: PMC4511696 DOI: 10.1016/j.rboe.2014.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Accepted: 06/21/2013] [Indexed: 12/16/2022] Open
Abstract
Hip arthroscopy has been popularized over the last decade and, with technical advances regarding imaging diagnostics, understanding of the physiopathology or surgical techniques, several applications have been described. Both arthroscopy for intra-articular conditions and endoscopy for extra-articular procedures can be used in diagnosing or treating different conditions. This updated article has the objective of presenting the various current possibilities for hip arthroscopy.
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10
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Polesello GC, Pereira Guimarães R, Ricioli Júnior W, Keiske Ono N, Kiyoshi Honda E, Cavalheiro de Queiroz M. Possibilidades atuais da artroscopia do quadril. Rev Bras Ortop 2014. [DOI: 10.1016/j.rbo.2014.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Abstract
The increasing popularity and success of hip arthroscopy has led to the development of related techniques for treating hip pathologies external to the joint proper. These minimally invasive endoscopic procedures serve in a diagnostic role to complement clinical evaluations and offer a therapeutic alternative to traditional open techniques. The indications for extra-articular hip endoscopy continue to expand. Recent literature describes applications for treating greater trochanteric pain syndrome, internal snapping hip, deep gluteal syndrome, and subspine impingement and for diagnosing and treating extra-articular sources of hip pain in patients who have undergone hip arthroplasty.
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Affiliation(s)
- Michael S. Reich
- Department of Orthopaedic Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106 USA
| | - Claire Shannon
- Department of Orthopaedic Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106 USA
| | - Eugene Tsai
- Department of Orthopaedic Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106 USA
| | - Michael J. Salata
- Department of Orthopaedic Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106 USA
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Verhelst L, Guevara V, De Schepper J, Van Melkebeek J, Pattyn C, Audenaert EA. Extra-articular hip endoscopy: A review of the literature. Bone Joint Res 2012; 1:324-32. [PMID: 23610664 PMCID: PMC3626189 DOI: 10.1302/2046-3758.112.2000133] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 10/11/2012] [Indexed: 12/17/2022] Open
Abstract
The aim of this review is to evaluate the current
available literature evidencing on peri-articular hip endoscopy
(the third compartment). A comprehensive approach has been set on
reports dealing with endoscopic surgery for recalcitrant trochanteric
bursitis, snapping hip (or coxa-saltans; external and internal),
gluteus medius and minimus tears and endoscopy (or arthroscopy)
after total hip arthroplasty. This information can be used to trigger
further research, innovation and education in extra-articular hip
endoscopy.
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Affiliation(s)
- L Verhelst
- AZ Groeninge Kortrijk, Burgemeester Vercruysselaan 5, 8500 Kortrijk, Belgium
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