Browse
Submit Data
Databases
API
Help

Dataset Information

30 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Combined hip arthroscopy and periacetabular osteotomy: indications, advantages, technique, and complications.

ABSTRACT: Evaluation and treatment of concomitant intra-articular pathology may be beneficial before periacetabular osteotomy (PAO) is performed. Hip arthroscopy before PAO allows the surgeon to perform full inspection of the hip joint and can be used to treat hip pathology before osteotomy. The indications for hip arthroscopy before PAO are presented in this article. The combined surgical procedure is described, along with potential complications. The advantages and disadvantages of this technique are outlined.

SUBMITTER: Domb BG

PROVIDER: S-EPMC4017955 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Similar Datasets

Modifications to the Hip Arthroscopy Technique When Performing Combined Hip Arthroscopy and Periacetabular Osteotomy.

Project description:In the realm of hip preservation, hip arthroscopy is often used to address intra-articular impingement pathology, whereas periacetabular osteotomy (PAO) is used to address dysplasia and instability. Indications to combine these 2 procedures include hip dysplasia and symptomatic instability with a concomitant symptomatic labral tear or the other symptomatic intra-articular pathology (i.e., loose body, chondral flap). The arthroscopic portion of the procedure allows repair of the injured labrum and close inspection of the hip joint, and the PAO addresses undercoverage and/or inappropriate version of the acetabulum. The open approach used in PAO also allows access to the peripheral compartment to debride a cam lesion, if present, and the subspine region is accessible to perform subspine decompression, if needed. In this technique, we highlight special considerations pertaining to hip arthroscopy that is performed in combination with a PAO. Hip arthroscopy is the first procedure that takes place in this combined case, and modifications to the standard hip arthroscopic technique can prevent unnecessary difficulty during the PAO that follows.

| S-EPMC5799490 | biostudies-literature

Technique for Intraoperative Neuromonitoring During Periacetabular Osteotomy After Concomitant Hip Arthroscopy.

Project description:Intraoperative neurologic injury during periacetabular osteotomy (PAO) for the treatment of symptomatic acetabular dysplasia is a major complication that can lead to permanent disability and limit the benefit of correcting the acetabular dysplasia. Current literature reflects the evolution of hip-preservation surgery for symptomatic acetabular dysplasia to include hip arthroscopy to address the intra-articular abnormalities, including labral tears, chondral lesions, and femoral cam morphology. A growing number of young hip surgeons and surgeon teams are subscribing to this approach and now performing concomitant hip arthroscopy and PAO. The value of intraoperative neuromonitoring cannot be understated, both in terms of surgeon confidence as well as patient safety, particularly during the learning curve of PAO, with or without hip arthroscopy. We present our current technique for the application of neuromonitoring to allow free mobility of the operative leg and continuous monitoring during PAO. This reproducible technique allows the use of nonsterile neuromonitoring to be used through a sterile conduit, positioned to allow free mobility of the operative extremity and performance of the PAO. We believe this technique provides additional safety benefit and increases awareness regarding neurologic compromise, particularly for the low-volume PAO surgeon or during the procedural learning curve.

| S-EPMC7695750 | biostudies-literature

Single Table Concomitant Post-Less Hip Arthroscopy Combined with Periacetabular Osteotomy for Hip Dysplasia.

Project description:It has been well established that both arthroscopic and open hip preservation techniques can result in improved patient outcomes and interrupt the natural history of hip disease. Traditionally, hip arthroscopy has been used to address central and peripheral compartment disease consisting of labral tears, impingement morphology and cartilage pathology. The periacetabular osteotomy has been the most used treatment for hip instability caused by inadequate acetabular coverage of the femoral head or dysplasia. With failures of periacetabular osteotomy linked to postoperative impingement and the high incidence of intra-articular pathology in the dysplastic hip, there has been a great interest in combing hip arthroscopy with the periacetabular osteotomy. Here, we describe a technique for a single table, single drape, postless combined hip arthroscopy, and periacetabular osteotomy.

| S-EPMC6928460 | biostudies-literature

Concomitant Arthroscopy With Labral Reconstruction and Periacetabular Osteotomy for Hip Dysplasia.

Project description:In the setting of true hip dysplasia, the high prevalence of intra-articular pathology may lead to recurrent symptoms and failure after periacetabular osteotomy (PAO). Femoral neck osteochondroplasty, microfracture, removal of loose bodies, and labral repair are examples of procedures that are performed with concomitant arthroscopy. When damage to the labrum is too severe to repair, reconstruction instead of extensive debridement before PAO can be more effective in restoring the labral seal to maintain joint lubrication and chondral protection. This Technical Note describes a method for concomitant hip arthroscopy with circumferential labral reconstruction with allograft and PAO.

| S-EPMC6262138 | biostudies-literature

The Use of Combined Hip Arthroscopy and Periacetabular Osteotomy for Hip Dysplasia Is Increasing and Has Low Complication Rates

Project description: Not available

| S-EPMC11240039 | biostudies-literature

Combined Hip Arthroscopy and Periacetabular Osteotomy (PAO): Technical Focus on Arthroscopically Elevating the Iliocapsularis and Performing the Open PAO.

Project description:In this Technical Note, we discuss the combined hip arthroscopy and periacetabular osteotomy (PAO) for the treatment of symptomatic hip dysplasia, with a focus on the technique we use for the PAO. We identify modifications that can be made during the arthroscopic portion of the procedure to assist in the PAO dissection, including arthroscopic capsular closure and arthroscopic elevation of the iliocapsularis muscle off the capsule, which allows for expedited open exposure during the PAO.

| S-EPMC8556612 | biostudies-literature

Efficiency and Accuracy of Bernese Periacetabular Osteotomy for Adult Hip Dysplasia.

Project description:Bernese periacetabular osteotomy (PAO) has several advantages dealing with adolescents and adults acetabular dysplasia. The authors introduced the details and steps performing PAO, with attached video and schematic diagram which demonstrates a perfect PAO in efficiency and accuracy. The patient is an 18-year-old girl, complaining hip pain on the left side for 6 months. Physical examination shows normal gait and range of motion (ROM) of the left hip. Pelvic anteroposterior X-ray shows acetabular dysplasia on the left, and post operation on the right. She is very satisfied with the PAO on the right one year before, so we recommend PAO for the left hip dysplasia again. The key point of PAO includes 4 cuts: ischial cut, pubic cut, acetabular roof cut, and quadrilateral bone cut, and the four cuts should be accomplished accurately. Then the acetabular fragment should be turned to ideal position with the lateral CE angle (LCE) > 25°, the Tönnis acetabular angle 0°, the anterior CE angle (ACE) > 20°, good congruence joint space, and with the hip center medialized slightly. At lastly the acetabular fragment is fixed with proper nails and instruments. The patient is very happy to the surgery with no hip pain, with normal gait, ROM, and Harris hip scores (HHS). In summary, PAO is a relative new and efficient procedure for adult hip dysplasia, requiring accurate techniques. Cadaveric practice and familiar with the local anatomy can help the surgeon overcome the learning curve quickly.

| S-EPMC5063177 | biostudies-literature

Hip arthroscopy: less invasive technique.

Project description:The popularity of hip arthroscopy has increased significantly over the past decade. It is technically demanding and may be associated with complications such as iatrogenic damage to the articular cartilage or acetabular labrum, compression injuries to the structures in the perineum, and distraction injuries to the leg. Some of these complications can be avoided by paying meticulous attention to the technique and reducing the traction/surgical time. We describe a technique by which the risk of injury to the articular cartilage may be minimized by introduction of the surgical instruments under direct vision, rather than under radiologic control. The described technique is likely to reduce the operating time by addressing the peripheral-compartment pathologies first-without traction. Traction is only required for the central-compartment procedures. Exposure to ionizing radiation is also diminished (eliminated with practice) because the portals are established under direct vision of the arthroscopist.

| S-EPMC3986488 | biostudies-literature

The Tutankhamun Technique in Hip Arthroscopy.

Project description:Hip arthroscopy has been increasing tremendously in the past decade and is a very common surgical procedure to repair femoroacetabular impingement. To access the hip joint, distraction is mandatory to treat intra-articular disorders such as labral tears, cartilage loose bodies, and ligamentum teres tears and to evaluate the condition of the femoral head and acetabular cartilage. To distract the hip, counterdistraction is needed, and this is achieved with placement of a bulky and cushioned perineal post. Most of the described techniques in hip arthroscopy use a perineal post, whereas others use beanbags to place the patient's body on the surgical table. Still others do not use a post at all but rather use gravity and a Trendelenburg position to achieve distraction. Our technique does not use a perineal post but instead uses heavy-duty tape over the patient's upper body, which is placed on a normal operating room table to distract the hip while entering the central compartment.

| S-EPMC6262244 | biostudies-literature

Endoscopy-Assisted Periacetabular Osteotomy.

Project description:Minimizing soft tissue dissection and improving visualization of vital structures during periacetabular osteotomy (PAO) is of paramount importance to improve patient outcome and minimize complications. The endoscopy-assisted PAO was introduced to accomplish this objective. It involves an initial hip arthroscopy, for treatment of central compartment pathology, followed by a mini-open Bernese periacetabular osteotomy under fluoroscopic and endoscopic guidance, and completed by final dynamic hip arthroscopy to assess acetabular reorientation and fixation and to perform femoroplasty in relation to the new acetabular rim position, if needed. Endoscopy-assisted PAO is used to treat dysplasia or acetabular retroversion in a minimally invasive fashion.

| S-EPMC4912685 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data