Journal of Hip Preservation Surgery最新文献

The Journal of Hip Preservation Surgery (JHPS) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, that finds its way into journals other than our own. There is much to learn from it, and so JHPS has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what JHPS hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes ….

The Journal of Hip Preservation Surgery (JHPS) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, which finds its way into journals other than our own. There is much to learn from it, and so JHPS has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what JHPS hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes ….

To perform a systematic review that identifies the percentage of arthroscopic hip surgery publications that obtain postoperative plain radiographs (and type, and when) and the accuracy of the osseous corrections performed. A systematic review was conducted utilizing PRISMA guidelines. Arthroscopic hip preservation surgery publications were included over a 20-year publication eligibility period. Synthetic reviews were excluded. Studies reporting accuracy of correction based on intra-operative fluoroscopic and/or dynamic arthroscopic examination alone, but without postoperative plain radiographs, were excluded. Publications were screened for the presence, type, and timing of postoperative radiographs and measurements performed quantifying femoral head-neck junction sphericity. Descriptive statistics and logistic and multivariate regression analyses were performed. Two-hundred fifty-six publications (29 381 hips; 14 692 female; mean age range 14.8-65.8 years). The most common surgical indication was labral tear (13 112 hips [44.7% of hips]). There was an inverse correlation between publication year and obtaining postoperative radiographs (r = -0.128, P < .05). Only 69 publications (27%) reported obtaining postoperative radiographs. Among those, 40 publications (16%) specified the type of radiographs. Only 22 publications (9%; 1538 hips [5% of hips]) reported that patients had an accurate osseous correction. This systematic review has shown that only 9% of arthroscopic hip preservation surgery publications (5% of hips) reported an accurate osseous correction on postoperative radiographs. Given this finding, writers, reviewers, editors, and publishers of hip preservation surgery literature should necessitate the transparent reporting of the accuracy of osseous corrections performed on standardized radiographs. Level IV, systematic review and/or meta-analysis of studies with Levels I to IV.

Due to the low prevalence of iliopsoas cysts, as well as the technical challenges involved in locating cysts from outside the joint capsule during arthroscopic surgery, there is a lack of comprehensive arthroscopy technique and clinical literature on this topic. We conducted a retrospective analysis and follow-up of five patients with iliopsoas cysts treated arthroscopically, over the past 3 years. Patient ages ranged from 39 to 73 years, with a mean age of 54 years. Our surgical approach involves the utilization of the outside-in technique to access and excise the cysts, along with potential concurrent procedures such as repair or debridement of the acetabular labrum. Each patient had a follow-up duration exceeding 23 months. The outcomes revealed significant pain relief and hip joint function improvement in all patients postoperatively. The Visual Analogue Scale scores reduced from a mean of 5.75 ± 0.43 preoperatively to 1.00 ± 0.70 postoperatively (P < .01), and the Modified Harris Hip Score increased from 50.75 ± 4.43 to 86.00 ± 4.47 (P < .01). For individuals presenting with symptoms of groin pain in the presence of a radiologically confirmed iliopsoas cyst, hip arthroscopy using the outside-in technique represents a minimally invasive and reliable approach for cyst removal.

Subjective interpretation of magnetic resonance imaging (MRI) findings in the setting of early hip osteoarthritis can be challenging with little agreement between surgeons. While arthroplasty is rarely indicated for patients with preserved joint space, it may be the preferred surgical option when advanced imaging reveals severe intra-articular pathology. The purpose of this study was to evaluate a semiquantitative MRI-based scoring system in patients undergoing surgery for hip pain without advanced radiographic joint space loss. Consecutive patients with hip pain refractory to conservative measures and without severe radiographic hip osteoarthritis [Tönnis grade 0-1, Joint Space Width (JSW)> 3 mm] who received primary total hip arthroplasty with a preoperative MRI were included. This cohort was propensity-matched by Tönnis grade and JSW, as well as age, gender, and BMI, to patients undergoing hip preservation surgery. Preoperative MRIs were evaluated according to the Scoring Hip Osteoarthritis with MRI (SHOMRI) grading system. SHOMRI scores were compared between the arthroplasty and hip preservation cohorts with threshold values calculated to evaluate associations with treatment pathways. Patients undergoing arthroplasty had significantly greater SHOMRI total scores as well as cartilage component scores. Threshold values for the cartilage component SHOMRI score were significantly associated with the designated surgical treatments between the two groups (P < .001). Subjects in each treatment group had significant postoperative improvement to the 2-year time point with high postoperative satisfaction, indicating appropriate treatment designation. Application of SHOMRI scoring thresholds may decrease subjectivity in surgeon decision making when using advanced imaging in patients without significant radiographic osteoarthritis.

Correct quantification of femoral version (FV) is crucial for femoroacetabular impingement (FAI) patients for diagnosis and for surgical planning. However, different measurement methods for FV and different normal values are confusing. The study aimed to investigate differences in FV measurement methods and to review normal FV. This retrospective comparative study investigated a total of 84 hips for FV measurement: 48 hips (asymptomatic patients) and 36 hips (asymptomatic volunteers) without hip pain. The 48 patients underwent computed tomography (CT) for another reason (mean age 63 ± 11 years) and most (39 hips, 81%) were male patients. The 36 hips reported no hip pain at the time of magnetic resonance imaging (MRI) (mean age 27 ± 7 years, 20 female patients, 56%). FV was measured on CT or MRI included pelvis and knee) and with the Murphy method. Mean FV for 48 hips was 22° (range 5-34°), and for 36 hips, it was 24° (7-44°). No significant differences were found between the two groups. For 39 male patients with CT scans, the mean FV was 21° (6-34°) and was significantly (P = 0.041) decreased compared to female patients (FV of 26°). For the review, 18 studies were compared that evaluated normal FV (total of 2275 hips) in the literature. Increasing values for normal FV were found for measurement methods with a more distal definition of the femoral neck axis: Normal values were reported for the Lee method (most proximal definition; 8-11°), Reikeras method (9-20°), Oblique/Jarrett method (9-15°), Tomczak method (22-24°), and Murphy method (most distal: 18-23°). Reported normal range of FV differs between measurement methods. This is important for patients with FAI/hip dysplasia undergoing hip preservation surgery (hip arthroscopy/femoral derotation osteotomy).