Page 33 - Layout 1

CURRENT CONCEPTS

Hip Arthroscopy: As with any evolving surgical field scientific, evidence
is lacking. Currently there is a paucity of data in the
Current Advances
literature documenting long-term outcomes after
hip arthroscopy, and few studies have reported
and Scientific Evidence
outcomes on these newer surgical techniques.
As well, limited studies have been performed

comparing arthroscopic to more traditional open
surgical techniques. Having said that, in a recent

Aaron J. Krych, MD
Hip Arthroscopy Theme issue in the Journal Knee
Department of Orthopedic Surgery Sports Traumatology and Arthroscopy

Surgery, Mayo Clinic and (KSSTA), a plethora of new scientific data has just
Mayo Foundation, Rochester, been published.

MN, USA
In this newsletter we will review the Theme issue
manuscripts to give the reader a more thorough

understanding of most “up-to-date” scientific
evidence pertaining to hip arthroscopy.

Additional Authors:
While randomized controlled trials are still lacking

Volker Musahl MD2
in this field, the KSSTA theme issue highlights
Bruce A Levy MD1
39 original articles with increased knowledge in
1 Department of Orthopedic Surgery, Mayo Clinic and
the areas of diagnosis of hip pathology, labral
Mayo Foundation, Rochester, Minnesota
function, outcome of hip arthroscopy, areas of novel
2 Department of Orthopedic Surgery, University of
treatment, and complications of hip arthroscopy. As
Pittsburg, Pittsburg, Pennsylvania
hip surgeons, we must carefully assess the scientific

Hip arthroscopy is a rapidly evolving field, and the literature to review indications and advance surgical
number of cases performed each year in the US has techniques to ultimately improve the outcomes for
our patients.
increased dramatically. From 2006 to 2010 alone,
there was a 600% increase cited in one registry.

Symptomatic femoral acetabular impingement with
labral tear remains the most common indication
for hip arthroscopy, but as our instrumentation and

surgical techniques become more refined, the ability
to treat patients with a wide variety of hip disorders

has made hip arthroscopy one of the most exciting
areas in orthopedic surgery.

From a surgical standpoint, we typically divide

the hip into three areas: the central compartment,
the peripheral compartment, and the peri-

trochanteric space. In general, access to the central
compartment allows treatment of acetabular rim

(Pincer) lesions, labral tears, loose bodies, chondral
injuries, ligamentum teres tears, and internal 01
snapping from the iliopsoas tendon. The peripheral

compartment allows treatment of loose bodies, and
femoral neck (CAM) lesions and the peri-trochanteric

space allows treatment of trochanteric bursitis,
external snapping hip and gluteus medius and

minimus (so-called “rotator cuff of the hip”) tears.

Clinical outcomes after arthroscopic hip surgery
have demonstrated excellent clinical success.

Patients with femoral acetabular impingement and
labral tear in particular have been able to return to

high levels of function and even professional sport
with this operation. The decision to recommend
hip arthroscopy is based on patient factors,

symptomatology, imaging findings, physical
examination, and patient expectations.
02

ISAKOS NEWSLETTER 2014: Volume II 31