Article Abstract

Strategies in revision hip arthroscopy

Authors: Seper Ekhtiari, Ryan P. Coughlin, Nicole Simunovic, Olufemi R. Ayeni

Abstract

With the recent increase in the use of hip arthroscopy, revision hip arthroscopy has also become more prevalent. Managing patients with residual and/or recurrent symptoms following hip arthroscopy is diagnostically and technically challenging. It is important to be aware of the most common reasons for failure, such as bony under-resection, labral tear or re-tear, progression of degenerative joint disease, and missed concurrent disorders such as subspine impingement, snapping hip syndrome, and athletic pubalgia. It is also important to rule out extra-articular causes of hip pain, such as referred pain from the spine or trochanteric bursitis. Pre-operative planning is of paramount importance if revision surgery is being considered, and three-dimensional modalities [such as magnetic resonance imaging and computed tomography (CT) with 3D reconstruction] are often required. Appropriate patient selection, honest discussions about potential outcomes, and management of patient expectations are important before proceeding with revision surgery. Intra-operatively, there are specific techniques and assistive technologies (e.g., fluoroscopy, navigation) that can aid in achieving a successful revision. Specific techniques have been developed for use in revision settings, such as labral and/or capsular reconstruction/grafting, remplissage for bony under-resection, and chondral implantation.

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