Hip Arthroscopy - My Worst Day in the Operating Room in 2020: What Happened and How it Changed My Practice (2021 Annual Meeting)-Hip Arthroscopy - My Worst Day in the Operating Room in 2020: What Happened and How it Changed My Practice-Maak

Hip Arthroscopy - My Worst Day in the Operating Room in 2020: What Happened and How it Changed My Practice-Maak

Video Transcription

Video Summary

This video presents a complex case of a 16-year-old female soccer player with groin pain who underwent hip arthroscopy for femoroacetabular impingement (FAI). Postoperatively, she experienced an early "pop" and instability episodes, eventually diagnosed with an osteochondral fracture and labral failure. Imaging revealed joint effusion, bone edema, labral tear, and capsular disruption. The discussion emphasized the importance of early imaging following postoperative trauma, meticulous capsular repair, and individualized surgical planning. The surgeons debated whether additional procedures like a periacetabular osteotomy might be needed for borderline hip dysplasia or instability. The case highlighted that hip hypermobility and borderline dysplasia increase risk of complications. Key lessons include always repairing the capsule, using high-strength non-absorbable sutures, avoiding psoas tendon release in hypermobile hips, and closely monitoring postoperative "pop" events with MRI. Rehabilitation must focus on restoring hip extension to prevent gait abnormalities. This case changed practice to prompt imaging and more careful capsular management after postoperative injury.

Asset Caption

Dr. Travis Maak

Keywords

hip arthroscopy

femoroacetabular impingement

osteochondral fracture

labral tear

capsular repair

borderline hip dysplasia