Microfracture in Hip Arthroscopy. Keep It Simple!
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ABSTRACT:
SUBMITTER: Maldonado DR
PROVIDER: S-EPMC6848960 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Many patients are afflicted with painful conditions affecting both hips, most commonly femoroacetabular impingement. Some patients prefer the advantage of undergoing a single surgical procedure and anesthetic followed by a single postoperative rehabilitation program. We present a Technical Note on single-stage bilateral hip arthroscopy. This Technical Note reports on key steps enabling safe and efficient performance of bilateral arthroscopic acetabuloplasty, labral refixation, femoroplasty, and dynamic testing while limiting traction times and facilitating rapid transition to the second hip arthroscopic surgery. Enabling factors include supine positioning with bilateral mobile leg spars, rapid surgical and hip traction times, and postoperative rehabilitation with immediate weight bearing as tolerated. A rationale for deciding which hip should undergo arthroscopy first is also offered. Concurrent bilateral hip arthroscopy is a viable option for select patients and experienced surgical teams, enabling potentially expedited recovery and return to work or sport with inherent cost savings.
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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.
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