Research

Endoscopic Sciatic Nerve Decompression in the Prone Position – An Ischial-Based Approach

Deep gluteal syndrome is described as sciatic nerve entrapment in the region deep to the gluteus maximus muscle. The entrapment can occur from the piriformis muscle, fibrous bands, blood vessels, and hamstrings. Good clinical outcomes have been shown in patients treated by open and endoscopic means. Sciatic nerve decompression with or without piriformis release provides a surgical solution to a difficult diagnostic and therapeutic problem. Previous techniques have used open methods that can now performed endoscopically.

Endoscopic Iliopsoas Tenotomy for Iliopsoas Impingement on a Collared Femoral Prosthesis

Groin pain after total hip replacement is an uncommon event and may be the result of several causes, including iliopsoas impingement. We describe the case of a 51-year-old woman who was diagnosed with iliopsoas impingement after total hip replacement with a collared femoral stem. She did not improve despite extensive conservative treatment. She was treated by endoscopic iliopsoas tenotomy, and the surgical technique is described herein. Her preoperative groin pain and popping disappeared completely at 3 months postoperatively.

Joint-preserving Surgical Options for Management of Chondral Injuries of the Hip

Management of injuries to the articular cartilage is complex and challenging;it becomes especially problematic in weight-bearing joints such as the hip. Several causes of articular cartilage damage have been described, including trauma, labral tears, and femoroacetabular impingement, among others. Because articular cartilage has little capacity for healing, nonsurgical management options are limited. Surgical options include total hip arthroplasty, microfracture, articular cartilage repair, autologous chondrocyte implantation, mosaicplasty, and osteochondral allograft transplantation. Advances in hip arthroscopy have broadened the spectrum of tools available for diagnosis and management of chondral damage. However, the literature is still not sufficiently robust to draw firm conclusions regarding best practices for chondral defects. Additional research is needed to expand our knowledge of and develop guidelines for management of chondral injuries of the hip.

Arthroscopic Labral Base Repair in the Hip: Clinical Results of a Described Technique

The purpose of this study was to evaluate the clinical outcomes of a cohort of patients who underwent labral repair by use of a previously published labral base repair suture technique for the treatment of acetabular labral tears and pincer-type femoroacetabular impingement (FAI). Methods: Patients who received hip arthroscopy for symptomatic intra-articular hip disorders and underwent the previously described labral base repair technique were included in the study group. Patients who had Tönnis arthritis grade 2 or greater, had Legg-Calves-Perthes disease, or underwent simple looped stitch repair were excluded.

Arthroscopic Capsular Plication and Labral Preservation in Borderline Hip Dysplasia

This study demonstrates that patients with borderline dysplasia can be successfully managed with hip arthroscopy when a consistent surgical approach is taken that includes labral preservation and capsular plication. This surgical approach should be considered in the management of a patient who has sufficient acetabular coverage and does not require a PAO but has mild dysplasia that could be exacerbated with hip arthroscopy.

Arthroscopic Technique for Treatment of Femoroacetabular Impingement

With an increasing understanding of femoroacetabular impingement (FAI) and advancement of the surgical treatment in patients with FAI, various techniques have been published. Successful outcome after arthroscopic hip surgery depends on appropriately reshaping the bony architecture to allow for improved range of motion before impingement symptoms occur, with special attention to preserve the labrum and restore its function. We present our surgical technique for the arthroscopic treatment of FAI.

Epidemiology of Hip Injuries in the National Basketball Association: A 24-Year Overview

Pelvis, hip, and thigh injuries in professional basketball players are commonly extra-articular strains and contusions and represent a significant burden of injury. The actual amount of intra-articular hip disorders may be underesti- mated, as the awareness of these disorders has increased only in the past decade. With the awareness of the types of injuries that occur in this region, injury prevention strategies focused on these may be beneficial to players and teams at all levels of competition, not only professional- level athletes.

Surgical Dislocation of the Hip Versus Arthroscopic Treatment of Femoroacetabular Impingement: A Prospective Matched-Pair Study With Average 2-Year Follow-up

Favorable results were shown with both approaches, with significant improvement in all PRO measures and high patient satisfaction ratings. However, arthroscopic treatment of FAI showed greater improvement in the HOS-SSS and a higher absolute NAHS at an average 2- year follow-up.

Hip Arthroscopy for Labral Tears in Workers’ Compensation: A Matched-Pair Controlled Study

Our study demonstrated that patients with WC status started and ended with lower absolute scores. However, WC patients showed significant benefit from hip arthros- copy for labral tears and demonstrated a similar degree of improvement as the control group. Although patient and physician expectations may be adjusted accordingly in the WC population, these results support the use of hip arthroscopy for labral tears in the WC population.