Dataset Information

Outside-In Capsulotomy of the Hip for Arthroscopic Pincer Resection.

ABSTRACT: Hip surgical techniques have evolved significantly, transitioning from open techniques to arthroscopic techniques. Hip arthroscopy has many advantages over open techniques, including reduced trauma to surrounding tissues, reduced risk of infection, and improved patient-reported outcome measures. Hip arthroscopic techniques are now commonly used for pathologies such as femoroacetabular impingement (FAI). FAI can include cam, pincer, or mixed impingement. Through hip arthroscopy, FAI may be treated with a femoroplasty and acetabuloplasty along with addressing any labral pathology that may exist. Owing to the capsule playing an integral role in hip stability, surgeons are now mindful of the initial approach and closure on completion of the intra-articular procedure. The most common approach for capsulotomy is the inside-out approach. However, this approach can be difficult in patients with a large pincer deformity. The authors describe an outside-in approach to arthroscopic hip capsulotomy. This capsular approach helps protect the labrum and articular cartilage while preserving capsular tissue.

SUBMITTER: Narvaez MV

PROVIDER: S-EPMC7953016 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Outside-In Capsulotomy of the Hip for Arthroscopic Pincer Resection.

Narvaez Michael V MV Cady Adam A Serrano Brian B Youssefzadeh Keon K Banffy Michael M

Arthroscopy techniques 20210202 3

Hip surgical techniques have evolved significantly, transitioning from open techniques to arthroscopic techniques. Hip arthroscopy has many advantages over open techniques, including reduced trauma to surrounding tissues, reduced risk of infection, and improved patient-reported outcome measures. Hip arthroscopic techniques are now commonly used for pathologies such as femoroacetabular impingement (FAI). FAI can include cam, pincer, or mixed impingement. Through hip arthroscopy, FAI may be treate ...[more]

PMID: 33738193

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Project description:PurposeTo assess the correlation between changes in hip capsule morphology with improvements in patient-reported outcome (PRO) scores after arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) using the periportal capsulotomy technique.MethodsTwenty-eight patients with cam morphology FAIS (without arthritis, dysplasia, or hypermobility) were prospectively enrolled before arthroscopic labral repair and femoroplasty through periportal capsulotomy (anterolateral/midanterior portals) without closure. Patients completed the Hip Disability and Osteoarthritis Outcomes Score (HOOS) and had nonarthrographic 3T magnetic resonance imaging (MRI) scans of the affected hip before and 1 year after surgery. Anterior capsule thickness, posterior capsule thickness, anterior-posterior capsule thickness ratio, and proximal-distal anterior capsule thickness ratio were measured on axial-oblique MRI sequences. Pearson correlation coefficients were calculated to determine the association between hip capsule morphology and PRO scores.ResultsPostoperative imaging showed that for all 28 patients (12 female), labral repairs and capsulotomies had healed within 1 year of surgery. Analysis revealed postoperative decreases in anterior hip capsule thickness (1395.4 ± 508.4 mm3 vs 1758.4 ± 487.9 mm3; P = .003) and anterior-posterior capsule thickness ratio (0.92 ± 0.33 vs 1.12 ± 0.38; P = .02). Higher preoperative anterior-posterior capsule thickness ratio correlated with lower preoperative scores for HOOS pain (R = -0.43; P = .02), activities of daily living (ADL) (R = -0.43; P = .02), and sport (R = -0.38; P = .04). Greater decrease from preoperative to postoperative anterior-posterior capsule thickness ratio correlated with greater improvement for HOOS pain (R = -0.40; P = .04), ADL (R = -0.45; P = .02), and sport (R = -0.46; P = .02).ConclusionsPeriportal capsulotomy without closure demonstrates capsule healing by 1 year after arthroscopic FAIS treatment. Changes in hip capsule morphology including decreased anterior-posterior capsule thickness ratio after surgery may be correlated with improvements in patient pain, function, and ability to return to sports.Level of evidenceLevel II, prospective cohort study.

Dataset Information

Outside-In Capsulotomy of the Hip for Arthroscopic Pincer Resection.

Publications

Outside-In Capsulotomy of the Hip for Arthroscopic Pincer Resection.

Similar Datasets

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