IC 307-2024: The Failed Hip Arthroscopy: How to Successfully Manage (and Not Replace) It-IC307_The Failed hip Arthroscopy- How to Successfully Manage (and Not Replace) It_V2.mp4IC307_The Failed hip Arthroscopy- How to Successfully Manage (and Not Replace) It

IC307_The Failed hip Arthroscopy- How to Successfully Manage (and Not Replace) It_V2.mp4IC307_The Failed hip Arthroscopy- How to Successfully Manage (and Not Replace) It

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Video Transcription

Video Summary

In this session moderated by Mark Safran, discussed the evaluation and management of failed hip arthroscopies. The panel emphasized that understanding the underlying cause of failure—whether it's underresection, overresection, instability, rehabilitation issues, or misdiagnosis—is crucial for determining appropriate treatment. <br /><br />Key points included:<br />1. <em>Failed Arthroscopy Causes and Management</em>: Frequent causes include untreated Femoroacetabular Impingement (FAI) and hip instability. Revision strategies might involve addressing labral and capsular deficiencies, ensuring accurate diagnosis, and treating soft tissue issues.<br />2. <em>Scope or Open Surgery</em>: Hip dysplasia and version abnormalities were differentiated for deciding between arthroscopy and open surgery. Borderline dysplasia with certain threshold values in lateral center-edge angle and tonus angle may necessitate careful consideration for open procedures like Periacetabular Osteotomy (PAO).<br />3. <em>Instability and Labral Issues</em>: Labral deficiencies need careful evaluation. Recommendations for repair, reconstruction, or augmentation depend on labral tissue quality. Shane Ngo stressed the importance of biomechanically restoring labrum for hip stability. Mark Philippon highlighted that sometimes open surgery might be the clear choice if instability or labral defects are irreparable.<br />4. <em>Rehabilitation Protocols</em>: Proper post-operative rehabilitation techniques to prevent adhesions and tendonitis were debated. Mark Philippon recommended techniques like circumduction exercises and cautious use of braces; Andrea Spiker discussed manipulation under anesthesia for persistent stiffness.<br /><br />Overall, the panel encouraged a careful, case-by-case analysis, leveraging both arthroscopic and open surgical approaches judiciously based on specific patient needs and anatomical considerations.

Keywords

hip arthroscopy

failed arthroscopy

hip instability

femoroacetabular impingement

labral deficiencies

capsular deficiencies

revision strategies

open surgery

hip dysplasia

Periacetabular Osteotomy

rehabilitation protocols