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Hip Arthroscopy for Femoral Acetabular Impingement: A Bird's-Eye/En Face Perspective With Ultrasound Guidance and 3-Dimensional Hip Printing.

ABSTRACT: Femoral acetabular impingement is a common hip disorder that may prove debilitating to many patients. Surgical management is indicated by way of hip arthroscopy for impinging CAM and pincer acetabular lesions. Traditionally, fluoroscopy has been used for the intraoperative assessment of bony resection; however, many disadvantages include radiation risks, equipment demands, and more. With ultrasound-guided arthroscopy, we describe the use of 1:1 3-dimensional hip printed models through various visual perspectives of impinging lesions. Given the low cost of 3-dimensional hip printing, lack of radiation exposure, and tactile multiangular views, we propose a safer and more reproducible intraoperative technique to conventional fluoroscopy to achieve better resection and outcomes after femoral acetabular impingement surgery.

SUBMITTER: Ali MI

PROVIDER: S-EPMC6926318 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo evaluate clinical depression scores and functional outcomes following arthroscopic treatment of femoroacetabular impingement syndrome in patients with elevated preoperative depressive symptoms as defined by Patient-Reported Outcomes Measurement Information System for Depression (PROMIS-D).MethodsPatients with femoroacetabular impingement syndrome completed the PROMIS-D Computer Adaptive Test and additional patient-reported outcome (PRO) measures preoperatively and at the time of postoperative visits. Patients were categorized into preoperative clinically depressed (CD) and nonclinically depressed (NCD) groups based on preoperative PROMIS-D scores. Scores ≥55 correlate to mild clinical depression, and this cutoff was used to determine preoperative depression status. PROMIS-D scores and functional outcome scores were assessed at 6 months and a minimum of 1-year postoperatively.ResultsIn total, 100 patients were included with complete PROs at a minimum of 1-year follow-up. Of those included, 21 (21%) were categorized with preoperative CD. There were no differences in demographic or radiographic variables between the preoperative CD and NCD groups. At 6 months and 12 months postoperatively, the percentage of patients in the preoperative CD group with continued depression was 33.3% and 23.8%, respectively. Overall, 1-year change in PROMIS-D score for the CD group was -9.1 versus -0.8 in the NCD group (P = .001). There was no significant difference in rates of patients achieving patient acceptable symptom state between the preoperative CD and NCD groups.ConclusionsPatients with symptoms of preoperative CD, as defined by the PROMIS-D score, demonstrated significant improvement in depressive symptoms following hip arthroscopy. In addition, patients with CD preoperatively did not show decreased rates of achieving minimum clinically important difference or patient acceptable symptom state on postoperative PROs compared with patients with NCD.Level of evidenceLevel IV, therapeutic case series.

Dataset Information

Hip Arthroscopy for Femoral Acetabular Impingement: A Bird's-Eye/En Face Perspective With Ultrasound Guidance and 3-Dimensional Hip Printing.

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