AANA24 Hip All-Access Pass-GENERAL SCIENTIFIC SESSION: Hip in Prime Time (Main Stage)

Video Transcription

Video Summary

The ANDA24 General Scientific Session on hip preservation covered current concepts, techniques, and challenges in femoroacetabular impingement (FAI) and related hip pathologies. Dr. Mark Philippon emphasized evidence-based care for pre-arthritic hip patients, advocating early intervention tailored to patient specifics, highlighting mental health improvements post-FAI surgery, and discussing labral preservation, micro-instability, and biologics like TGF beta blockers and PRP to improve outcomes.<br /><br />Dr. Winston Gaufme focused on the importance of precise portal placement in hip arthroscopy, underscoring safety, optimal visualization, instrumentation efficiency, and safe anchor placement to avoid nerve and cartilage injury, stressing the anterior lateral portal as the first and key portal.<br /><br />A debate on labral treatment presented Dr. Mike Elman supporting labral augmentation to preserve native tissue and biomechanics in hypoplastic labra, while Dr. Ben Dohm advocated reconstruction for irreparable tissue, better sizing, and reproducibility.<br /><br />Dr. Robert Westerman discussed the impact of femoral anteversion abnormalities on FAI, emphasizing thorough evaluation and tailored treatment including osteotomies in cases with abnormal femoral version to restore hip stability.<br /><br />Dr. Andrea Spiker reviewed periacetabular osteotomy (PAO) basics, indications expanding beyond classic dysplasia to borderline cases, stressing individualized evaluation of coverage and instability and noting good long-term survivorship post-PAO.<br /><br />Dr. Mike Banfi presented cartilage restoration options, highlighting microfracture with biological scaffolds for acetabular cartilage defects primarily caused by CAM lesions, cautioning about lesion size and patient age influencing outcomes.<br /><br />Dr. Thomas Wurz addressed common hip arthroscopy complications, emphasizing careful technique to avoid labral penetration, nerve injury, instability, and adhesions, and advocating for patient communication and management.<br /><br />Dr. Jamie Gennario reviewed hip labral reconstruction, noting that while reconstruction restores structure better than debridement, native labral physiology is lost, and repair is preferred when possible; decision often made intraoperatively.<br /><br />A panel discussion analyzed a young dancer’s case with everted labrum and cam impingement, debating labral advancement versus reconstruction or leaving intact, highlighting the importance of addressing impingement and instability.<br /><br />Drs. Mario Havisi and Jovan Leskovski detailed hamstring and ischiofemoral impingement, and progressive endoscopic techniques for hamstring tear repair, emphasizing anatomy, nerve protection, and repair strategies including augmentation for large tears.<br /><br />Dr. Mike Banfi discussed endoscopic gluteus medius repair with biologic augmentation, noting improved outcomes and fewer complications compared to open surgery, and the importance of careful rehab.<br /><br />Finally, Dr. Shane Ngo showcased evolving endoscopic hamstring repair techniques with advanced suture configurations to replicate open biomechanical strength while minimizing complications.<br /><br />Overall, the session highlighted advancements in hip preservation, personalized treatment planning, surgical technique refinement, biologics, and management of complex pathology, aiming to optimize patient outcomes in FAI and related conditions.

Asset Caption

Introduction by Moderators: Andrea M. Spiker, M.D., Robert W. Westermann, M.D.

Keywords

hip preservation

femoroacetabular impingement

FAI surgery

labral preservation

micro-instability

biologics in hip surgery

hip arthroscopy portals

labral augmentation

labral reconstruction

femoral anteversion abnormalities

periacetabular osteotomy

cartilage restoration

hip arthroscopy complications

endoscopic hamstring repair