Contemporary Management of the Hip Capsule During Arthroscopic Hip Preservation Surgery-Reference-Cited by-同舟云学术

Contemporary Management of the Hip Capsule During Arthroscopic Hip Preservation Surgery

Published:2019-07-05 Issue:3 Volume:12 Page:260-270
ISSN:1935-9748
Container-title:Current Reviews in Musculoskeletal Medicine
language:en
Short-container-title:Curr Rev Musculoskelet Med

Author:

Nho Shane J.,Beck Edward C.,Kunze Kyle N.,Okoroha Kelechi,Suppauksorn Sunikom

Publisher

Springer Science and Business Media LLC

Subject

Orthopedics and Sports Medicine

Link

http://link.springer.com/content/pdf/10.1007/s12178-019-09564-4.pdf

Reference24 articles.

1. • Hoppe DJ, et al. The learning curve for hip arthroscopy: a systematic review. Arthroscopy. 2014;30(3):389–97 Purpose: the learning curve for hip arthroscopy is consistently characterized as “steep.” The purpose of this systematic review was to (1) identify the various learning curves reported in the literature, (2) examine the evidence supporting these curves, and (3) determine whether this evidence supports an accepted number of cases needed to achieve proficiency. Methods: the electronic databases Embase and Medline were screened for any clinical studies reporting learning curves in hip arthroscopy. Two reviewers conducted a full-text review of eligible studies and a hand search of conference proceedings and reference sections of the included articles. Inclusion/exclusion criteria were applied, and a quality assessment was completed for each included article. Descriptive statistics were compiled. Results: we identified 6 studies with a total of 1063 patients. Studies grouped surgical cases into “early” vs “late” in a surgeon’s experience, with 30 cases being the most common cutoff used. Most of these studies used descriptive statistics and operative time and complication rates as measures of competence. Five of 6 studies showed improvement in these measures between early and late experiences, but only one study proposed a bona fide curve. Conclusions: this review shows that when 30 cases were used as the cutoff point to differentiate between early and late cases in a surgeon’s experience, there were significant reductions in operative time and complication rates. However, there was insufficient evidence to quantify the learning curve and validate 30, or any number of cases, as the point at which the learning curve plateaus. As a result, this number should be interpreted with caution. Level of evidence: level IV, systematic review of level IV studies.

2. • Domb BG, et al. Arthroscopic capsulotomy, capsular repair, and capsular plication of the hip: relation to atraumatic instability. Arthroscopy. 2013;29(1):162–73 Purpose: the purpose of this systematic review was to critically evaluate the available literature exploring the role of the hip joint capsule in the normal state (stable) and pathologic states (instability or stiffness). Furthermore, we examined the various ways that arthroscopic hip surgeons address the capsule intraoperatively: (1) capsulotomy or capsulectomy without closure, (2) capsulotomy with closure, and (3) capsular plication. Methods: two independent reviewers (B.D.G. and B.G.D.) performed a systematic review of the literature using PubMed and the reference lists of related articles by means of defined search terms. Relevant studies were included if these criteria were met: (1) written in English, (2) levels of evidence I to V, (3) focus on capsule and its role in hip stability, and (4) human studies and reviews. Articles were excluded if they evaluated (1) total hip arthroplasty constructs using bony procedures or prosthetic revision, (2) developmental dysplasia of the hip where reorientation osteotomies were used, (3) syndromic instability, and (4) traumatic instability with associated bony injury. Results: by use of the search method described, 5,085 publications were reviewed, of which 47 met appropriate criteria for inclusion in this review. Within this selection group, there were multiple publications that specifically addressed more than 1 of the inclusion criteria. Relevant literature was organized into the following areas: (1) capsular anatomy, biomechanics, and physiology; (2) the role of the capsule in total hip arthroplasty stability; (3) the role of the capsule in native hip stability; and (4) atraumatic instability and capsulorrhaphy. Conclusions: as the capsuloligamentous stabilizers of the hip continue to be studied, and their role defined, arthroscopic hip surgeons should become facile with arthroscopic repair or plication techniques to restore proper capsular integrity and tension when indicated. Level of evidence: level IV, systematic review.

3. Ekhtiari S, de SA D, Haldane CE, Simunovic N, Larson CM, Safran MR, et al. Hip arthroscopic capsulotomy techniques and capsular management strategies: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017;25(1):9–23.

4. Mei-Dan O, et al. Catastrophic failure of hip arthroscopy due to iatrogenic instability: can partial division of the ligamentum teres and iliofemoral ligament cause subluxation? Arthroscopy. 2012;28(3):440–5 Hip arthroscopy is an evolving surgical tool, and with any new procedure, it is important to learn from the complications encountered. A patient with mild hip dysplasia and a symptomatic labral tear underwent uneventful hip arthroscopy and labral repair including partial debridement of a hypertrophied ligamentum teres. Despite preservation of the labrum, no pincer resection, and a modest capsulotomy, 3 months, subluxation and joint space narrowing were noted. One year, end-stage arthritis was present, requiring total hip replacement. Instability after hip arthroscopy is due to a number of factors, including excessive rim trimming, capsulotomy, overzealous labral resection, or inadequate labral repair. This report emphasizes the importance of the ligamentum teres and small disruptions of the capsule in patients with mild dysplasia.

5. Uchida S, Pascual-Garrido C, Ohnishi Y, Utsunomiya H, Yukizawa Y, Chahla J, et al. Arthroscopic shoelace capsular closure technique in the hip using Ultratape. Arthrosc Tech. 2017;6(1):e157–61.

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