The Failed Hip Arthroscopy - How to Successfully Manage (and Not Replace) It (AANA22)-Evaluation of the Patient w_Failed Hip Arthroscopy & Approach to Manage

Evaluation of the Patient w_Failed Hip Arthroscopy & Approach to Manage

Video Transcription

Video Summary

Mark Philippon discusses capsular deficiency and the causes of failed hip arthroscopy, emphasizing salvageable issues through non-operative and operative management. Key failure causes include residual impingement, instability (often underrecognized before surgery), stiffness due to adhesions or incomplete rehab, tendonitis, and diagnostic errors where pain origins are misattributed. Rehab is critical, especially with experienced therapists focusing on gluteus medius and iliopsoas strength. Proper diagnosis involves intra-articular anesthetic injections to confirm pain sources and recognizing conditions like iliopsoas tendonitis and hamstring dominance. Imaging, including 3D CT and collision software, assists in detecting residual bony impingement or over-resection. Capsular management is highlighted, noting the importance of repair to prevent instability. Labral issues and heterotopic ossification may also contribute to failure. Philippon stresses tailored treatment of the precise cause, suggesting that revision outcomes can be favorable if the underlying problem is correctly identified and managed.

Asset Caption

Marc. R. Safran, M.D.

Keywords

capsular deficiency

failed hip arthroscopy

residual impingement

hip instability

rehabilitation therapy

diagnostic imaging