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Current Reviews in Musculoskeletal Medicine
Published in: Current Reviews in Musculoskeletal Medicine 3/2020

01-06-2020 | Hip Arthroscopy | Outcomes Research in Orthopedics (O Ayeni, Section Editor)

Approach to a Failed Hip Arthroscopy

Published in: Current Reviews in Musculoskeletal Medicine | Issue 3/2020

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Abstract

Purpose of Review

Hip arthroscopy has seen increasing utilization over the last decade. This is largely related to increased recognition and improved techniques for treating femoroacetabilar impingement (FAI). Though hip arthroscopy generally yields favorable outcomes, there are a subset of patients who have residual or recurrent symptoms that require reoperation. The current review discusses an algorithmic approach to evaluating patients following a failed hip arthroscopy including a framework for clinical and radiographic assessment, available treatment options, and associated outcomes in revision surgery.

Recent Findings

Residual FAI has been demonstrated to be the most common indication for revision arthroscopy. Other indications include residual or recurrent labral pathology, gross instability, microinstability, or adhesions. Appropriate history and imaging are important to determine the cause for residual symptoms. Novel techniques including labral and capsular reconstruction, and modified remplissage procedures have been developed to deal with complex revision cases. Though studies have shown improved outcomes after revision surgery, they have been shown to result in inferior outcomes compared to a matched cohort following primary hip arthroscopy.

Summary

Management of a failed hip arthroscopy remains a complex problem. Focused history, cross-sectional imaging, and revision hip arthroscopy with novel techniques can improve outcomes, albeit to a lesser extent than patients undergoing successful primary hip arthroscopy. The information provided here can help guide treatment and set appropriate patient expectations for revision surgery.
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Metadata
Title
Approach to a Failed Hip Arthroscopy
Publication date
01-06-2020
Published in
Current Reviews in Musculoskeletal Medicine / Issue 3/2020
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-020-09629-9

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