AANA24 Hip All-Access Pass-CONCURRENT SCIENTIFIC SESSION 5B: Hip Papers and Cases!

Video Transcription

Video Summary

The session presented multiple studies and expert opinions focused on hip arthroscopy techniques, outcomes, and management of complex cases:<br /><br />1. Dr. Joseph Featherall compared periportal versus interportal capsulotomies in hip arthroscopy, finding both techniques similarly affect intraoperative axial distraction and that capsular repair restores resistance to distraction in both approaches.<br /><br />2. Dr. Andrea Spiker analyzed the impact of mental health on outcomes after hip arthroscopy for femoroacetabular impingement (FAI). She found preoperative anxiety and depression levels strongly correlate with pain and functional scores post-surgery, often more so than hip pathology itself, suggesting mental health screening and management preoperatively may improve outcomes.<br /><br />3. Dr. David Maldonado investigated clinical benefit thresholds for revision hip arthroscopy and found patients with BMI under ~26.4 were more likely to achieve substantial clinical improvements, emphasizing the importance of patient selection.<br /><br />4. Dr. Alan Zhang reported excellent one-year results using all suture-anchor fixation for proximal hamstring repair combined with an accelerated rehabilitation and bracing protocol, noting high satisfaction, low complication rates, and return to pre-injury sports in most patients.<br /><br />5. Dr. Sepedian presented 10-year follow-up data on endoscopic gluteus medius repairs performed with concomitant hip arthroscopy, demonstrating durable and significant improvements in pain and function without secondary abductor surgeries.<br /><br />6. Dr. Ryan Marder compared outcomes of endoscopic gluteus medius repair with and without dermal allograft augmentation, finding comparable patient-reported outcomes and low re-tear rates, suggesting augmentation may benefit patients with poor tissue quality.<br /><br />The expert panel discussed a challenging case of borderline hip dysplasia with recurrent instability and groin pain after prior labral repair without capsular closure. Opinions varied:<br /><br />- One expert favored revision labral repair with capsular plication.<br /><br />- Another supported labral reconstruction in irreparable cases with attention to capsular repair.<br /><br />- Dr. Spiker advocated combined revision labral repair, capsular reconstruction, and periacetabular osteotomy (PAO) to correct bony coverage and instability, highlighting PAO’s durability and capacity to address underlying pathology.<br /><br />Overall, the presentations underscored the importance of capsular management, mental health considerations, patient selection, surgical technique refinement, and the value of combined bony and soft tissue procedures in complex hip pathology.

Asset Caption

Moderators: Thomas H. Wuerz, M.D., M.Sc., Kelechi R. Okoroha, M.D.

Keywords

hip arthroscopy

periportal capsulotomy

interportal capsulotomy

mental health impact

femoroacetabular impingement

revision hip arthroscopy

BMI patient selection

proximal hamstring repair

endoscopic gluteus medius repair

labral repair techniques

periacetabular osteotomy