AANA25 Hip Access Pass-CONCURRENT SESSION 3B: Hip Papers

Video Transcription

Video Summary

The afternoon session focused on recent advances and research in hip arthroscopy, capsular management, and treatment of hip pathologies. <br /><br />Steve Aoki presented a biomechanical comparison of partial versus complete capsular closure using a periportal approach. He found unrepaired capsulotomies increase hip distractibility, while both partial and complete repairs restore stability, with some patient variation noted between sexes. Alan Zhang followed with clinical outcomes of periportal capsulotomy closure versus non-closure at two years, showing similar functional improvements regardless of closure, suggesting healing over time in non-hypermobile patients.<br /><br />Andy Kahana presented long-term outcomes for combined arthroscopy and periacetabular osteotomy (PAO) in dysplastic hips, reporting excellent radiographic correction, improved patient-reported outcomes, and 92% survivorship at 10 years. Allison Morgan investigated the impact of global acetabular retroversion in femoroacetabular impingement, showing similar 10-year outcomes and survivorship compared to non-retroverted hips, indicating arthroscopy remains effective without reorienting the acetabulum.<br /><br />Michael Bamfy highlighted capsular augmentation and reconstruction techniques, emphasizing the importance of capsular closure to restore joint stability. He discussed indications for augmentation, including revision cases and hypermobility, and described biological graft options, noting biomechanical benefits of iliotibial band grafts over dermal allografts.<br /><br />Additional presentations included a study showing proximal hamstring repair yields similar outcomes in patients over and under 60, a randomized trial demonstrating tranexamic acid (TXA) does not improve visual clarity during hip arthroscopy, and minimum 5-year favorable outcomes after labral reconstruction in adolescents.<br /><br />Regan Byer introduced novel radiographic measures (WISA and WISP) to better assess acetabular coverage in borderline dysplasia, which correlated with surgical decision-making. Finally, a spotlight on labral reconstruction techniques and patient selection was presented, emphasizing repair over reconstruction when possible and noting diminished survivorship in patients over 45 years.<br /><br />Panel discussions highlighted the nuances of radiographic assessment, capsular repair techniques, and the variable role of TXA, with experts stressing individualized approaches based on patient anatomy and pathology. Overall, the session underscored advances in biomechanical understanding, surgical techniques, and long-term outcomes that inform hip preservation strategies.

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Keywords

hip arthroscopy

capsular management

hip pathologies

periportal capsulotomy

capsular closure

biomechanical comparison

periacetabular osteotomy (PAO)

acetabular retroversion

capsular augmentation

labral reconstruction

tranexamic acid (TXA)