Hip and Pelvis Team

Alejandro Zylberberg Serman, Felipe Caroca Marazzi, Julio Madrid Pavez, Esteban Salazar Hernández & Claudio Rojas Ponce

RESULT OF THE HIP ARTHROSCOPY FOR TRAUMA

RESULT OF THE HIP ARTHROSCOPY FOR TRAUMA

We have no financial relationships to disclose.

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

Introduction• Traumatic injuries of the hip are frecuent and

affect acetabulum and femoral head andneck.

• This result in intra-articular pathologicfindings, including loose bodies, labral tears,cartilage tears and step deformities.

• Hip arthroscopy in determinated cases is agood option of treatment in the managementof this patients.

Minimally invasive Less morbility

Byrd T. Hip arthroscopy for post-traumatic loose fragments in the young active adult: three case reports. Clin J Sports Med 1996; 6:129-34Yamamoto Y. Usufulness of Arthroscopic Surgery in hip Trauma Cases. Journal Arthroscopic & Related Surg 2003; 9:269-73

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

Introduction

Labral tears Chondral tears Ligamentum teres tears Post traumatic FAI Loose boidies Hip Instability Arthroscopically assisted

osteosynthesis

Susceptibles tears for arthroscopic treatment describe in literature for trauma:

Yamamoto Y. Usufulness of Arthroscopic Surgery in hip Trauma Cases. Journal Arthroscopic & Related Surg 2003; 9:269-73

Marquez W. Artroscopia de la cadera en trauma. Serie de casos y revisión de la literatura. Rev Col. de Ort y Trauma; 2009; 23: 27 – 38

ISHA Annual Scientific Meeting 2014 Rio de Janeiro, October 9-11th

Purpose

To evaluate the middle-term results of the arthroscopy in the post traumatic intra-

articular hip pathology.

ISHA Annual Scientific Meeting 2014 Rio de Janeiro, October 9-11th

Methods

• Retrospective, case series study• Review intra-articular pathologic disorders in patients with post-traumatic injury

• January 2009 to March 2013• Hip Arthroscopy in patients with antecedent of hip trauma

• Evaluate:• Frequency of trauma in hip arthroscopy• Patients demographics• Pre operative diagnosis

• Functional evaluation:• NAHS (Non Arthritic Hip Score)• mHHS (Modified Harris Hip Score)• WOMAC (Western Ontario and McMaster Univerities Index System).

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

Results:235 Hip Arthroscopies / 12 antecedent of hip trauma

Frecuency of hip arthroscopy for trauma : 5,1%

• 10 cases were men.• Mean age: 32 años (range, 20 – 54). • Mean time from trauma to hip arhroscopy was 17 months.

(range, 7 days - 24 months)• All affected by labor compensation

Mean follow-up: 26 months (range, 8 – 56)

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

Results:

Nº %9 75% Car accident3 25% High level fall

Mechanism

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

42%25% 25%

8%0123456

10

11

AcetabularfxFemoralhead fxPelvic fx

Pre-operative diagnosis

Procedure

Functional evaluation

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

5661

6773 72

83

NAHS mHHS WOMAC

Pre-op Post-op

Results:

• Retrospective analysis of a case series of hip arthroscopy.

• Complementary tool in treatment of patients with hip trauma.

• Limited indications • Low frequency• Most traumatic injuries of the hip not require arthroscopy

• Lower morbidity compares with usual hip approaches.

• Satisfactory functional outcomes.

• Limitations: • Indication/inclusion criteria not standardized • Polytraumatized patients (comorbidities) • Learning curve of hip arthroscopy technique

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

Discussion:

Conclusion

Hip arthroscopy can solve in a minimally invasive procedure (with limited indications) post traumatic intra-articular

pathology avoiding conventional approaches, reducing the morbidity associated

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

References:

ISHA Annual Scientific Meeting 2014 October 9-11th, Rio de Janeiro

1. Yamamoto Y. Usufulness of Arthroscopic Surgery in hip Trauma Cases. Journal Arthroscopic & Related Surg 2003; 9:269-73

2. Byrd T. Hip arthroscopy for post-traumatic loose fragments in the young active adult: three case reports. Clin J Sports Med 1996; 6:129-34

3. Marquez W. Artroscopia de la cadera en trauma. Serie de casos y revisión de la literatura. Rev Col. de Ort y Trauma; 2009; 23: 27 – 38

4. Chernchujit B. Arthroscopic loose body removal after hip fracture dislocation: experiences in 7 cases. J Med Assoc Thai. 2009 Dec;92 Suppl 6:S161-4.

5. Mullis BH. Hip arthroscopy to remove loose bodies after traumatic dislocation. J Orthop Trauma. 2006 Jan;20(1):22-6.

6. Mella C. Arthroscopy after hip joint injury. Case studies and indications. Unfallchirurg. 2012 Mar;115(3):273-8.