Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Safety and efficacy of autologous adipose-derived stem cells for knee osteoarthritis in the elderly population: A systematic review","authors":"Biagio Zampogna ,&nbsp;Francesco Rosario Parisi ,&nbsp;Augusto Ferrini ,&nbsp;Andrea Zampoli ,&nbsp;Giuseppe Francesco Papalia ,&nbsp;Saseendar Shanmugasundaram ,&nbsp;Rocco Papalia","doi":"10.1016/j.jcot.2024.102804","DOIUrl":"10.1016/j.jcot.2024.102804","url":null,"abstract":"<div><h3>Introduction</h3><div>Osteoarthritis (OA) is a progressive joint disease, and over 240 million people suffer from symptomatic OA, primarily in the knee, and mainly affects the elderly population over 65. A combination of different risk factors leads to biological changes in the microenvironments of the joints, causing cartilage overload and chondrocyte aging. Adipose-derived MSCs (ADSCs) are demonstrated to improve joint environments with an effective therapy for Knee OA. This review focused on patients over 65 years old to evaluate the effectiveness of ADSC therapies in treating KOA in elderly patients and demonstrate that complications are not higher in this cohort of patients.</div></div><div><h3>Materials and methods</h3><div>We conducted a bibliography search through the PubMed, Scopus, and Cochrane databases for English-language and human clinical trials published until Feb 7, 2024. We extracted the following study characteristics: Authors, year of publication, type of study, number of patients, number of knees, sex, Kellgren-Lawrence classification, culture ADSC, Number of cells injected, mean follow-up, adverse events, significant complications, and clinical outcomes data were extracted recorded and analyzed.</div></div><div><h3>Results</h3><div>According to inclusion criteria, seven clinical trials on autologous adipose-derived stem cells were considered. Four studies analyzed stem cells as a stromal vascular fraction (SVF), two as ADSC cultured, and 1 study investigated the MAT procedure. All studies reported improved clinical outcomes using autologous adipose-derived stem cells, on 339 knees. Post-treatment increased KOOS, WOMAC, IKS, VAS, and Lysholm knee scores were highlighted. All studies showed an improvement in all outcomes scores, and regarding complications, only 44 knees underwent adverse events, but no significant complications were found in all the studies reported.</div></div><div><h3>Conclusions</h3><div>The current systematic review demonstrated that using autologous adipose-derived stem cells improved clinical outcomes and is effective and safe in elderly patients. Additionally, this study will encourage orthopedic surgeons not to consider surgery as the only solution in elderly patients who are refractory to treatment and do not show end-stage knee osteoarthritis.</div></div><div><h3>Level of evidence</h3><div>Level IV, systematic review of level IV studies<strong>.</strong></div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"59 ","pages":"Article 102804"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New evidence on patella resurfacing in modern total knee arthroplasty for all inflammatory arthritis in a mixed Asian population","authors":"Sherlyn Yen Yu Tham ,&nbsp;Wu Chean Lee ,&nbsp;Zavier Yongxuan Lim ,&nbsp;Remesh Kunnasegaran","doi":"10.1016/j.jcot.2024.102798","DOIUrl":"10.1016/j.jcot.2024.102798","url":null,"abstract":"<div><h3>Background</h3><div>Traditional teaching advocates for routine patella resurfacing (PR) during total knee arthroplasty (TKA) in patients with inflammatory arthritis. However, evidence on this topic remains limited in the Asian population. This study aims to evaluate the postoperative outcomes and complication of patella resurfacing (PR) during primary total knee arthroplasty (TKA) in Asian patients with inflammatory arthritis.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using registry data from our institution. Patients with inflammatory arthritis who underwent primary TKA from August 2017 to December 2021 were included in the study. Patients were divided into two groups - patella resurfaced (PR, n = 25) and non-resurfaced patella (PNR, n = 31) groups. Demographics, operative data, patient reported outcome measures, and complications were compared.</div></div><div><h3>Results</h3><div>Preoperative range of motion (ROM) (PR:95.3 ± 23.6° vs PNR:105 ± 19.5°, p = 0.106), Knee Society Scoring System Knee score (KS-KS) (PR:44.6 ± 17.4 vs PNR:49.3 ± 17.7, p = 0.331) and Knee Society Function Score (KS-FS) (PR:40.9 ± 27.3 vs PNR:47.7 ± 27.0, p = 0.325) and Oxford Knee Score (OKS) (PR:25.0 ± 7.8 vs PNR:23.3 ± 10.3, p = 0.525) were similar in both groups. Outcomes between PR and PNR groups at the one-year mark in terms of ROM (PR:112.7 ± 18.1 vs PNR:114.6 ± 16.5, p = 0.455), OKS (PR:41.5 ± 3.9 vs PNR:41 ± 4.7, p = 0.954), KS-KS (PR:84.5 ± 13.2 vs PNR:89.2 ± 9.3, p = 0.095) and KS-FS (PR:73.6 ± 18.3 vs PNR:78.7 ± 19.3, p = 0.173) were also similar. Intraoperative complication (PR:0/25 vs PNR: 3/31 (9.6 %), p = 0.245) and re-operation rates (PR: 1/25 (4 %) vs PNR: 1/31 (3.2 %), p = 0.877) were also similar in both groups.</div></div><div><h3>Conclusion</h3><div>This study conducted on a mixed Asian population with inflammatory arthritis demonstrated that the one-year postoperative ROM and functional outcomes, complication, and re-operation rates between PR and PNR groups were similar. Hence, routine patella resurfacing on all Asian patients with inflammatory arthritis undergoing TKA may not be necessary.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102798"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation from delayed bilateral complete quadriceps tendon repairs with knee extension assist braces: A case report","authors":"Benjamin Hewins,&nbsp;Sara Sparavalo,&nbsp;Ivan Wong","doi":"10.1016/j.jcot.2024.102789","DOIUrl":"10.1016/j.jcot.2024.102789","url":null,"abstract":"<div><div>Simultaneous bilateral quadriceps tears are rare with fewer than 150 cases reported in the literature and typically occur in male patients greater than 40 years of age. If left untreated or with delayed clinical intervention, these injuries often lead to chronic disability including pain and reduced ambulation. Typical treatments include surgical repair with considerable post-operative rehabilitation and a guarded prognosis. However, given the scarcity of these cases, a consensus on a standard course of treatment remains unclear and ultimately at the discretion of the clinician.</div><div>A 67-year-old male presented 6-months after complete, retracted tears of bilateral quadriceps tendons after a fall onto both knees in flexion. Treatment included: immediate bilateral quadriceps tendon repairs, immobilization, physiotherapy, and the daily use of novel tri-compartment offloader knee braces providing knee-extension assist. To our knowledge, this is the first report of a full return to independent ambulation following a delayed diagnosis and surgical intervention of complete bilateral quadriceps tendon tears.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102789"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing surgical treatment of De Quervain's tendinopathy: A retrospective cross-sectional observational study","authors":"Arjuna Thakker ,&nbsp;Nicholas Johnson ,&nbsp;Joseph Dias","doi":"10.1016/j.jcot.2024.102790","DOIUrl":"10.1016/j.jcot.2024.102790","url":null,"abstract":"<div><h3>Background</h3><div>The literature surrounding how different patient, sociodemographic, and anatomical factors influence surgical treatment of De Quervain's tendinopathy (DQT) is limited.</div></div><div><h3>Purpose</h3><div>We hypothesised that different patient, anatomical, or sociodemographic factors influence the management of DQT with regard to non-operative vs. surgical management.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study reviewed 155 cases of patients with DQT seen over a 10 year period. Patient-specific factors included age, gender, hand affected, dominant hand, steroid injection given and mean number of injections. Sociodemographic factors included ethnicity, employment, and deprivation, were measured using deprivation quintiles through The Index of Multiple Deprivation. Anatomical factors included the presence of subcompartmentalization, number of APL and EPB tendon slips, tendon thickening, exudative tenosynovitis, hypervascularization, and the presence of a sheath ganglion Patients were categorized into either non-operative or surgical cohort. Bivariate analysis was used to compare factors between the cohorts, and significant factors (p &lt; 0.05) were included in the logistic regression model, used to predict factors influencing surgical management.</div></div><div><h3>Results</h3><div>Bivariate analysis detected a significant difference in the mean number of steroids given between the non-operative and surgical cohort (p = 0.001) patient factors. For sociodemographic factors, a significant difference was found between deprivation quintiles (p = 0.02). From the anatomical factors, the surgical cohort had more patients with multiple APL tendon slips (p = 0.02) and the presence of a tendon ganglion sheath ganglion (p = 0.02). For patient and sociodemographic factors, logistic regression identified that the number of steroids (per patient) and being in deprivation quintile 4 were associated with surgical treatment. For anatomical factors, multiple APL tendon slips and the presence of a tendon sheath ganglion were associated with the surgical treatment.</div></div><div><h3>Conclusion</h3><div>This study suggests that several factors are associated with the need for surgical treatment of DQT, including the number of steroid injections received, social deprivation, and anatomical factors, such as the presence of multiple tendon slips and a tendon sheath ganglion. Our findings add to the growing body of literature exploring factors that may influence treatment pathways for patients with DQT.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102790"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucor mycosis of tibia: A case report of An unsolved entity","authors":"Lavindra Tomar,&nbsp;Gaurav Govil","doi":"10.1016/j.jcot.2024.102793","DOIUrl":"10.1016/j.jcot.2024.102793","url":null,"abstract":"<div><div>Mucormycosis of tibia is a highly aggressive fungal infection. It is an uncommon affection especially in immunocompromised host who have more propensity for such affections.</div><div>The nonhealing ulcer of the left leg in an immunocompromised host status of a 45-year-old male presented with a radiological lytic lesion of the distal lower fourth of tibia. The initial biopsy confirmed tubercular affection which responded to antitubercular medications to allow radiological healing. However, the repeat biopsy showed Mucormycosis which remained recalcitrant to antifungal medications with unresponsive wound healing and persisting suppuration. The case presented unique scenario of superadded fungal infection in a healing tubercular osteomyelitis tibia with alcoholic liver disease compromised host immunity.</div><div>The fungal infection of tibia remains an unsolved entity with poor clinical and functional outcomes. An early detection, high degree of suspicion with an adequate dosage of antifungal medications may allow resolution of the dreaded infection though an effective treatment remains an unsolved entity.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102793"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostics and surgical treatment of ruptured Baker's cysts: A prospective study","authors":"Murodjon E. Irismetov ,&nbsp;Kudratbek K. Tursunov ,&nbsp;Kobiljon T. Khudayberdiev ,&nbsp;Markhabo A. Tursunova ,&nbsp;Yulia Roitblat","doi":"10.1016/j.jcot.2024.102792","DOIUrl":"10.1016/j.jcot.2024.102792","url":null,"abstract":"<div><h3>Aims</h3><div>We assessed diagnostic and arthroscopic surgery challenges the ruptured Baker's cysts (RBC) cases may present compared to intact Baker's cyst cases (IBC). The main question to explore was: Is RBC arthroscopic surgery more complex than IBS surgery? The null hypothesis was that RBC cases might present additional, and specific challenges for a surgeon and the arthroscopic procedure may be more complicated.</div></div><div><h3>Methods</h3><div>The prospective cohort study analyzed 100 operated patients (43 % female; mean age 61 ± 9.5 years) (2005–2022; follow-up to August 2023) diagnosed with RBC. The comparison group consisted of 100 operated patients (48 % female; mean age 57 ± 12.5 years) with IBC. We compared diagnostic challenges, surgical approaches, functional outcomes, the rates of postsurgical complications and recurrence, durations of surgery and immobilization, and the time to recovery.</div></div><div><h3>Results</h3><div>Among statistically significant results, RBCs were more frequently detected during the differential diagnosis with thrombophlebitis (28 vs. 17, p = 0.04) and by 99m-Tc-MDP radiography (30 vs. 10, p = 0.03). They frequently involved a three-port arthroscopic approach (89 vs. 71, p = 0.04), the cyst wall preservation (p = 0.03), and had the eight-day shorter time to recovery (p = 0.05). Other above-mentioned variables were similar in both groups of patients.</div></div><div><h3>Conclusion</h3><div>RBCs do not present an additional challenge for a surgeon if an arthroscopic technique is used, but the diagnostic process may be challenging. Most RBCs require a three-port arthroscopic approach and permit cyst wall preservation.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102792"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common elbow injuries in children","authors":"Gaurav Gupta ,&nbsp;Sudhanshu Bansal ,&nbsp;Chinmay Sangole","doi":"10.1016/j.jcot.2024.102554","DOIUrl":"10.1016/j.jcot.2024.102554","url":null,"abstract":"<div><div>Elbow injuries are one of the commonest paediatric musculoskeletal injuries. Their spectrum varies from pulled elbow to elbow dislocation. Supracondylar fractures are the most common type of paediatric elbow fractures accounting for 65–75 % of all paediatric elbow injuries. Other common paediatric elbow injuries include Lateral condyle fractures, Medial epicondyle fractures, Radial neck fractures, olecranon fractures, TRASH injuries and Elbow dislocations. Osteochondral fractures in kids can be missed due to their benign appearance or invisibility on x rays. TRASH stands for “The Radiological Appearance Seems Harmless”. In contrast to the full form, the abbreviation TRASH tells the harmful consequences of missing these injuries. This article will discuss the salient points regarding common elbow injuries, their diagnosis and best treatment practices. It will help the caregivers to be more prepared to deal with these situations and thus avoiding complications and getting better outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102554"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating antimicrobial resistance in osteoarticular infections: Current strategies and future directions","authors":"Madhan Jeyaraman ,&nbsp;Tarun Jayakumar ,&nbsp;Naveen Jeyaraman ,&nbsp;Arulkumar Nallakumarasamy ,&nbsp;Swaminathan Ramasubramanian ,&nbsp;Sathish Muthu ,&nbsp;Vijay Kumar Jain","doi":"10.1016/j.jcot.2024.102791","DOIUrl":"10.1016/j.jcot.2024.102791","url":null,"abstract":"<div><div>The emergence of antimicrobial resistance (AMR) has profoundly impacted the management of osteoarticular infections (OAIs), presenting significant challenges for healthcare systems worldwide. This review provides a comprehensive overview of the current landscape of AMR in OAIs, emphasizing the necessity for assertive and innovative strategies to combat this escalating health threat. It discusses the evolution of resistance among key pathogens, including ESKAPEE organisms, and the implications for treatment protocols and healthcare outcomes. The importance of antibiotic stewardship programs (ASPs) is highlighted as a core strategy to optimize antibiotic use and mitigate the development of resistance. Additionally, the review explores the potential of pharmacological approaches, including novel antibiotic regimens and combination therapies, alongside surgical interventions and alternative therapies such as bacteriophage-based treatments and probiotics, in managing these complex infections. The role of rapid diagnostic methods in improving treatment accuracy and the critical need for global surveillance to track AMR trends are also examined. By integrating insights from recent literature and expert recommendations, this review underscores the multifaceted approach required to address the challenge of AMR in OAIs effectively. It calls for a concerted effort among clinicians, researchers, and policymakers to foster innovation in treatment strategies, enhance diagnostic capabilities, and implement robust stewardship and surveillance programs. The goal is to adapt to the evolving landscape of OAIs and ensure optimal patient care in the face of rising AMR.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102791"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing orthopaedic seat cushion made of rattan using quality function deployment approach","authors":"Lina Gozali ,&nbsp;Ambrosius Milano Lo'o Ukeng Watun ,&nbsp;Lamto Widodo ,&nbsp;Syuhaida Ismail ,&nbsp;Abdoulmohammad Gholamzadeh Chofreh ,&nbsp;Dyah Erni Herwindiati ,&nbsp;Ariawan Gunadi ,&nbsp;Feybi Ariani Goni ,&nbsp;Sani Susanto ,&nbsp;Wan Hee Cheng","doi":"10.1016/j.jcot.2024.102771","DOIUrl":"10.1016/j.jcot.2024.102771","url":null,"abstract":"<div><div>Using ergonomic orthopaedic chairs can address spinal issues, particularly HNP, due to their flexible and elastic properties. By achieving optimal ergonomic design, various positive aspects can be achieved, such as increasing work quality productivity and reducing the cost of injuries or accidents. This research demonstrates diverse product design approaches to enhance posture health ergonomics, address specific musculoskeletal disorder issues, and consider local needs and available materials. Rattan is a tropical vine widely used in the furniture industry and predominantly found in wooded areas such as Indonesia. This research combines market research, morphology, ergonomic study, concept selection, QFD, HoQ, stiffness test, and prototype review. The QFD method was chosen in this study due to its excellence in connecting consumer desires with the product development process. Data of respondents consist of 51 % of respondents were male, 49 % were female, 88 % were aged between 18 and 34 years old, and 10 % were aged between 35 and 54 years old. The approach of 6 stages of product design as the primary framework for developing our product such as: planning, concept development (concept screening, product morphology, concept selection), system-level design, detailed design, testing, refinement and launching. Based on the calculations using the HOQ, it is identified that the primary focus in designing the rattan-based orthopaedic seating, lies in the orthopaedic design that provides maximum comfort for the spine. The comparison results indicate that the stiffness level of rattan weaving is nearly like latex, with a similarity percentage of 89 %. Data analysis using the QFD method indicates that the primary priority aspect is the orthopaedic design, followed by the selection of quality materials, cost-effectiveness, versatility, and appealing design aspects. Rattan's superior air circulation provides comfort by preventing excessive heat accumulation, excellence in strength and durability, ensuring ease of lightweight modelling, and providing more sustainable material.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102771"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and complications of hip arthroscopy for femoroacetabular impingement syndrome: A narrative review","authors":"Cara Mohammed ,&nbsp;Ronny Kong ,&nbsp;Venkataramana Kuruba ,&nbsp;Vikramaditya Rai ,&nbsp;Shahzad Waqas Munazzam","doi":"10.1016/j.jcot.2024.102797","DOIUrl":"10.1016/j.jcot.2024.102797","url":null,"abstract":"<div><div>Hip arthroscopy has emerged as the primary surgical intervention for Femoroacetabular Impingement Syndrome (FAIS), a common cause of hip pain in young adults, particularly athletes. This narrative review examines the long-term outcomes, complications, and debates surrounding arthroscopic management of FAIS. Key findings include sustained improvements in patient-reported outcomes, return to sport, and functional recovery, particularly in younger patients and those with cam-type FAIS. However, some patients may eventually require total hip arthroplasty (THA), highlighting the variability in long-term durability. Complications, though infrequent, remain a significant concern, with the most common being transient neuropathy due to prolonged traction, heterotopic ossification, and iatrogenic cartilage damage. Recent studies emphasize the importance of patient selection, with younger patients, those with capsular closure, and those without pre-existing osteoarthritis showing superior outcomes. Additionally, sex-based differences suggest females may experience higher complication rates, though they often report better functional improvements post-surgery. Areas of ongoing debate include the role of labral debridement versus repair, the optimal management of mixed-type FAIS, and the potential benefits of adjunctive procedures such as ligamentum teres debridement. Future research should focus on refining surgical techniques and identifying patient-specific factors to further optimize outcomes. Despite its complexities, hip arthroscopy remains an effective treatment for FAIS, though individualized treatment plans are crucial to addressing the unique needs of each patient. By synthesizing current evidence, this review aims to guide clinicians in optimizing FAIS management and identifying areas for future research.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"58 ","pages":"Article 102797"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}