.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.jpg)
Outcome Analysis of Hip Arthroscopy
Abstract
Hip arthroscopy has evolved significantly over last two decades. Many procedures are being done arthroscopically as our understanding increases. However, in many countries, including Pakistan, Hip arthroscopy is in its infancy. We present our outcome of Hip arthroscopy. To the best of our knowledge this is the first report of outcome after hip arthroscopy in our local literature.
Material and Methods: We prospectively reviewed our first sevenconsecutive hip arthroscopy patients. The outcome was measured using modified Haris Hip score. The common indications in our set up were: septic hip (primary and post THR) and synovial pathology.
Results: Out of seven patients one lost to follow up. Of the remaining sixpatients, four had hip infection. One of these cases was post Total Hip Replacement. In two patients hip arthroscopy was done for synovial pathology.
In all the patients with septic arthritis, there was significant improvement – mean preop modified Harris hip score was 33.1(range 24-43) which increased to 56.8 (Range 29-71) after debridement except one patient with infected THR. The mean follow up of these patients is 6.6 months( range3-10 months). Mean length of hospital stay was 2.6 days (range 1-4) Two patients developed transient neuropraxia which resolved spontaneously.
Conclusion: Hip arthroscopy is a promising technique in selected patients with major advantages of reduced surgical trauma and excellent 360 degrees visualization of joint and shorter hospital stay . However, there is a steep learning curve. With careful portal placement and appropriate skills, hip arthroscopy has minimized the surgical trauma to access to hip joint.
References
1. Dennis R. Roy. Arthroscopy of the hip in children and adolescents. J Child Orthop. 2009 April; 3(2): 89–100.Published online 2008 November 18. doi: 10.1007/s11832-008-0143-8
2. Burman M. Arthroscopy or the direct visualization of joints. J Bone Joint Surg. 1931;4:669–695.
3. Suzuki S, Awaya G, Okada Y, Maekawa M, Ikeda T, Tada H Arthroscopic diagnosis of ruptured acetabular labrum. Acta Orthop Scand. 1986 Dec; 57(6):513-5.
4. Dienst M, Kohn D.Hip arthroscopy. Minimal invasive diagnosis and therapy of the diseased or injured hip joint]. Unfallchirurg. 2001 Jan;104(1):2-18. [Article in German]
5. Byrd JW. Hip arthroscopy: patient assessment and indications. Inst Course Lect. 2003;52:711–719.
6. Dennis R. Roy, Arthroscopy of the hip in children and adolescents. J Child Orthop. 2009 April; 3(2): 89–100 .Published online 2008 November 18. doi: 10.1007/s11832-008-0143-8
7. Martin RL, Philippon M (2008) Evidence of reliability and responsiveness for the hip outcome score. Arthroscopy 24:676–682. doi:10.1016/j.arthro.2007.12.011.
8. Byrd JW Hip arthroscopy utilizing the supine position. Arthroscopy ; 1994);10:275–280. doi:10.1016/S0749-8063(05)80111-2.
9. Eriksson E, Arvidsson I, Arvidsson H (1986) Diagnostic and operative arthroscopy of the hip. Orthopedics 9:169–176
10. Byrd JW, Jones KS. Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med. 2004;32(7):668–674.
11. Czerny C, Kramer J, Neuhold A, Urban M, Tschauner C, Hofmann S. Magnetic resonance imaging and magnetic resonance arthrography of the acetabular labrum: comparison with surgical findings. ROFO Fortschr Geb Rontgenstr Nuklearmed.2001;173(8):702–707
12. Keeney A, Peelle MW, Jackson J, Rubin D, Maloney WJ, Clohisy JC Magnetic resonance arthrography versus arthroscopy in the evaluation of articular hip pathology. Clin Orthop Relat Res (2004) 429:163–169. doi:10.1097/01.blo.0000150125.34906.7d.
13. El-Sayed [80 J Child Orthop. 2008 Jun;2(3):229-37. doi: 10.1007/s11832-008-0094-0. Epub 2008 Mar 6.Treatment of early septic arthritis of the hip in children: comparison of results of open arthrotomy versus arthroscopic drainage.
14. Heyworth BE, Shindle MK, Voos JE, Rudzki JR, Kelly BT. Radiologic and intraoperative findings in revision hip arthroscopy. Arthroscopy 2007;23:1295–1302)
15. Lo YP, Chan YS, Lien LC, et al. Complications of hip arthroscopy: analysis of seventy three cases. Chang Gung Med J 2006;29:86–92.)
16. Griffin DR, Villar RN. Complications of arthroscopy of the hip. J Bone Joint Surg [Br] 1999;81-B:604–606
17. Souza BG, Dani WS, Honda EK, et al. Do complications in hip arthroscopy change with experience? Arthroscopy 2010;26:1053–1057.
18. Eriksson E, Arvidsson I, Arvidsson H. Diagnostic and operative arthroscopy of the hip. Orthopedics 1986;9:169
19. Dennis R. Roy. Arthroscopy of the hip in children and adolescents. J Child Orthop. 2009 April; 3(2): 89–100. Published online 2008 November 18. doi: 10.1007/s11832-008-0143-8
20. Wenger DE, Kendell KR, Miner MR, Trousdale RT. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res. 2004 Sep;(426):145-50.
21. A. V. Papavasiliou , N. V. Bardakos. Complications of arthroscopic surgery of the hip. Bone Joint Res. 2012 July; 1(7): 131–144. Published online 2012 July 1. doi: 10.1302/2046-3758.17.2000108
22. Kelly BT, Williams RJ, III, Philippon MJ. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med. 2003;31(6):1020–1037
