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

ABSTRACT: 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.

SUBMITTER: Woyski D

PROVIDER: S-EPMC6928460 | biostudies-literature |

REPOSITORIES: biostudies-literature

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

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

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| S-EPMC7695750 | biostudies-literature

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.

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

Project description: Not available

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

Project description: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.

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

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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.

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The association between periacetabular osteotomy reorientation and hip joint reaction forces in two subgroups of acetabular dysplasia.

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| S-EPMC6930321 | biostudies-literature

Sports activity participation after curved periacetabular osteotomy for acetabular dysplasia.

Project description:BackgroundCurved periacetabular osteotomy (CPO) was developed to treat acetabular dysplasia. Given that CPO can improve physical function in the early post-operative period, patients might be able to participate in sports activities post-operatively. Therefore, this study examined the post-operative sports activity participation and characteristics of acetabular dysplasia patients who have undergone CPO.MethodsA total of 52 patients who underwent CPO for acetabular dysplasia were given a questionnaire on pre- and post-operative sports activities; 43 patients responded. We surveyed patients' sports activities, satisfaction, and physical function. Patients were divided according to whether they participated in sports activities after CPO. Physical function was compared before and after CPO.ResultsThe pre- and post-operative sports activity participation rates were 55.8 and 72.1%, respectively. Patients mostly performed low-impact sports activities. Moreover, patients who participated in sports activities post-operatively had smaller pre-operative range of motion of hip flexion and returned to full weight bearing earlier.ConclusionsAmong acetabular dysplasia patients who underwent CPO, 72.1% participated in sports activities post-operatively. Post-operatively, patients participated not only in low-impact sports activities, but also in high-impact ones. These findings might be useful for advising patients who are concerned about participating in sports activities after CPO.

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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

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