Dataset Information

Evaluation of hip arthroscopy using a hip-specific distractor for the treatment of femoroacetabular impingement.

ABSTRACT:

Background and study aims

Hip arthroscopy using an orthopaedic traction table has been associated with traction-related neurovascular complications. Since the use of a hip-specific distractor for performing hip arthroscopy hasn't been associated with those specific complications we hypothesized that a hip-specific distractor might facilitate the learning curve of hip arthroscopy for beginner surgeons.

Material and methods

We reviewed retrospectively the first 56 hip arthroscopies performed to treat femoro-acetabular impingement using a hip-specific distractor. We tried to analyse the learning curve of this procedure using operative time, peri- and postoperative complications, hospital stay and patient satisfaction. We also evaluated pre- and postoperative sports activities and tried to identify some factors as poor postoperative prognostic factors.

Results

Only 1 major complication occurred. No traction-related complications have been encountered. The curves analysing intervention time and postoperative satisfaction rate showed improvement after 30 cases performed. In all cases, we were able to perform the whole planned gesture without difficulties accessing the hip joint.

Conclusion

The hip-specific distractor is a safe and reproducible method in performing hip arthroscopy without any traction-related complications or time limits.

SUBMITTER: Charles T

PROVIDER: S-EPMC7877656 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Evaluation of hip arthroscopy using a hip-specific distractor for the treatment of femoroacetabular impingement.

Charles Tatiana T Jayankura Marc M

PloS one 20210211 2

<h4>Background and study aims</h4>Hip arthroscopy using an orthopaedic traction table has been associated with traction-related neurovascular complications. Since the use of a hip-specific distractor for performing hip arthroscopy hasn't been associated with those specific complications we hypothesized that a hip-specific distractor might facilitate the learning curve of hip arthroscopy for beginner surgeons.<h4>Material and methods</h4>We reviewed retrospectively the first 56 hip arthroscopies ...[more]

PMID: 33571305

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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.

Project description:PurposeWe aimed to determine the relationship between recreational sports and intra-articular hip injuries in an active population that had undergone hip arthroscopy for femoroacetabular impingement syndrome.MethodsA retrospective review was performed of prospectively collected data from patients undergoing hip arthroscopy between January 2015 and December 2016. Inclusion criteria included patients between 18 and 50 years of age who had participated in recreational sports prior to surgery and had a minimum of a 2-year follow-up. Labral injury was evaluated using the Multicenter Arthroscopic Hip Outcome Research Network classification, and rim chondral injuries were evaluated using the Acetabular Labral Articular Disruptions system. Ligamentum teres tear and psoas impingement were also recorded. Sports were classified as rotational running (soccer, basketball, handball), flexibility (martial arts, dance), asymmetric-overhead (racquet), or endurance (running, swimming, cycling). Primary univariate analysis of sports' independent associations, demographic characteristics, intra-articular hip injuries, and outcomes was performed.ResultsPatients included 185 people with a mean age of 36.7 years. Patients participating in rotational running sports and flexibility sports had a significantly greater proportion of rim chondral injuries than those participating in endurance sports or asymmetric overhead sports (P = 0.02). Ligamentum teres tears were significantly associated with flexibility sports (P < 0.001). A total of 84.7%, 67.7%, 67.2%, and 71.2% of patients met minimal clinically important difference levels for the modified Harris Hip Score (mHHS), the Hip Outcome Score (HOS)10 questionnaire with activities of daily living (HOS-ADL), the sports subscale (HOS-SSS), and the International Hip Outcome Tool (iHOT-12), respectively; 94.9%, 66.2% and 62.7% met the patient acceptable symptom state for mHHS, HOS-ADL, and HOS-SSS, respectively; 86.7%, 48.5%, 47.8%, and 32.4% found substantial clinical benefit for mHHS, HOS-ADL, HOS-SSS, and iHOT-12, respectively.ConclusionsRotational running sports were significantly associated with rim chondral injuries. Flexibility sports were significantly associated with rim chondral injuries and ligamentum teres tears. Athletes participating in these sports are more likely to have intra-articular hip injuries than those in the other sports categories.Level of evidenceLevel IV, prognostic case series.

Project description:PURPOSE:To provide estimates of postoperative opioid use after hip arthroscopy for femoroacetabular impingement (FAI) syndrome and to identify risk factors for increased postoperative opioid use. METHODS:All patients aged at least 18 years who were undergoing hip arthroscopy for FAI syndrome performed by 1 of 2 hip-preservation surgeons between November 2015 and August 2016 were eligible for inclusion in this study. Target minimum enrollment was set at 30 patients per surgeon based on an a priori sample size calculation. Enrolled patients completed the International Hip Outcome Tool, visual analog pain scale, Pain Catastrophizing Scale, abbreviated Patient Health Questionnaire, and questions regarding demographic characteristics and opioid and anti-inflammatory use. Opioid consumption was assessed through pill counting at 2- and 6-week postoperative appointments. Of 80 patients enrolled, 67 had complete 2- and 6-week opioid use data. Patient and operative factors were correlated with outcomes in multivariate models. RESULTS:Opioid use in the 2 weeks before surgery was significantly associated with higher postoperative opioid use at 2 weeks postoperatively (253.8 additional oral morphine equivalents [OMEs]; 95% confidence interval [CI], 171.2-336.5 additional OMEs; P < .0001; n = 73) and 6 weeks postoperatively (385.3 additional OMEs; 95% CI, 241.6-529.0 additional OMEs; P < .0001; n = 67). By 6 weeks postoperatively, 41 of 52 patients (79%) without opioid use in the 2 weeks before surgery used 30 or fewer 5-mg oxycodone pills compared with only 2 of 15 patients (13%) with preoperative use (odds ratio, 24.9; 95% CI, 4.2-148.5; P < .0001). CONCLUSIONS:Among patients undergoing hip arthroscopy for FAI syndrome, any opioid use in the 2 weeks preceding surgery was the strongest predictor of opioid use after hip arthroscopy. The impact of preoperative opioid use far exceeded the impact of other baseline patient and operative factors. Assessment of preoperative opioid use could be an important factor in guiding postoperative opioid prescribing. LEVEL OF EVIDENCE:Level II, prospective observational study.

Dataset Information

Evaluation of hip arthroscopy using a hip-specific distractor for the treatment of femoroacetabular impingement.

Background and study aims

Material and methods

Results

Conclusion

Publications

Evaluation of hip arthroscopy using a hip-specific distractor for the treatment of femoroacetabular impingement.

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