AANA Fellowship Education - Hip Arthroscopy: Peripheral Compartment-Presentation (PDF)

Presentation (PDF)

Pdf Summary

This webinar, held on May 25, 2021, focuses on hip arthroscopy with an emphasis on managing the peripheral compartment, particularly addressing femoroacetabular impingement syndrome (FAIS) and CAM deformities. Faculty included Drs. Thomas H. Wuerz, Marc J. Philippon, Shane J. Nho, and Benedict U. Nwachukwu.<br /><br />The session began with introductions, followed by Dr. Nho discussing CAM impingement pathomechanics, focusing on optimizing CAM resection. He highlighted key strategies: thorough preoperative planning using imaging, proper surgical access, execution via dynamic hip motion, and intraoperative understanding through X-rays. He emphasized the importance of complete and precise CAM resection to improve outcomes and reduce failure rates.<br /><br />Dr. Nwachukwu covered capsular management techniques, comparing periportal, interportal, and T-capsulotomy approaches. Although capsulotomy type does not affect overall outcomes, proper capsule closure is crucial. Data suggests complete closure yields better functional outcomes and fewer revisions than partial closure. Capsular reconstruction with iliotibial band allograft may be needed for severe capsular deficiency.<br /><br />Dr. Philippon provided tips for peripheral compartment management. He advised releasing traction and flexing the hip during surgery to optimize visualization, using motorized burrs cautiously around critical vascular structures. Dynamic intraoperative assessment ensures proper osteoplasty and avoids over- or under-resection. Capsule closure should preserve key ligaments and restore stability; techniques include side-to-side suturing and capsular plication.<br /><br />A clinical case of a 24-year-old former soccer player with groin pain showcased the application of subspine (AIIS) and CAM decompression with successful long-term outcomes, including restored femoral neck offset and capsule healing.<br /><br />The webinar concluded with resources for further education and AANA membership benefits, emphasizing lifelong learning, networking, and access to research and surgical tools. Key references support the discussed concepts in imaging, natural history, and surgical anatomy of FAIS and hip capsule management.

Keywords

hip arthroscopy

peripheral compartment

femoroacetabular impingement syndrome

FAIS

CAM deformities

CAM resection

capsular management

capsule closure

osteoplasty

capsular reconstruction