2023 Specialty Day Access Pass-Case Discussion

Video Transcription

Video Summary

The video discusses complex cases of patients with persistent hip pain after previous arthroscopy, focusing on diagnosis, imaging, and surgical planning. The panel examines X-rays, CTs, and MRIs revealing residual cam deformities, labral issues, adhesions, and capsular defects. They emphasize the importance of precise assessment to decide between debridement, repair, augmentation, or reconstruction of the labrum and capsule. Adhesions often cause recurrent pain, and selective injections help clarify diagnoses. For labral insufficiency, augmentation with grafts like IT band or acellular dermal allograft is preferred, with careful surgical technique to avoid overtightening sutures. The final case highlights a patient with hip dislocation post-arthroscopy due to capsular failure, requiring urgent repair or reconstruction, typically done arthroscopically using specialized suture techniques and grafts. The panel shares pearls to optimize outcomes and minimize complications. The session concludes with consensus on individualized approaches for revision hip arthroscopy focusing on restoring stability and function.

Asset Caption

Moderators: Shane J. Nho, M.D., M.S., Sharon L. Hame, M.D.
Panel: Michael J. Salata, M.D., Benedict U. Nwachukwu, M.D., Stephen K. Aoki, M.D., Marc J. Philippon, M.D.

Keywords

persistent hip pain

hip arthroscopy revision

labral augmentation

capsular reconstruction

imaging diagnosis