Hip Arthroscopy: Contraindications

Description

Dr Jonathan Vigdorchik shares his insights whilst discussing a clinical case involving a 46-year-old female presenting with progressive groin pain, indicated by positive impingement signs during her physical examination. Dr Vigdorchik elaborates on the relevant diagnostic tests, including the Fader test, which raises suspicion for a labral tear, confirmed by MRI showing both a labral tear and a small cam lesion on the proximal femur. The importance of evaluating the acetabulum is highlighted, particularly in cases of acetabular dysplasia, which poses a contraindication for hip arthroscopy. He cautions that performing hip arthroscopy on patients over 40 years old or with arthritis greater than grade 2 is less successful and may lead to complications requiring total hip replacement. The audio emphasizes proper patient selection for hip arthroscopy and alternative treatments, such as periacetabular osteotomies, noting that patients can often find themselves in a challenging situation where they are not suitable candidates for either preventive or corrective surgical options. However, recent studies support total hip replacement as a viable solution for this demographic, showing promising outcomes.

DOI: 10.1302/3114-251141

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