10/30/19 1 OAOS 2019 ● Portland, Oregon Update on Hip Arthroscopy OAOS 2019 Lucas Korcek, MD Eugene, Oregon 1 Disclosures I have nothing to disclose 2 Background Hip arthroscopy continues to expand as a tool to address multiple hip pathologies Many current practitioners were not exposed to hip arthroscopy in their formal training 3 Purpose • Overview: Many applications of hip arthroscopy in orthopedic surgery • Focus: Femoral acetabular impingement (FAI) and labral tear treatment 4 Hip / Pelvic Pain: Diagnosis Burnett JBJS 2006 21 months: Average time from injury to accurate diagnosis 3.3: Average number of providers seen before definitive treatment 5 6 Orthopaedic causes Bone/joint Femoroacetabular impingement (FAI) Acetabular labral tears Osteitis pubis Stress fractures: Pubic ramus/femoral neck Degenerative hip joint disease Avascular necrosis of the femoral head Slipped capital femoral epiphysis Avulsion fracture: ASIS/AIIS/Ischium Muscle Athletic pubalgia Hockey player’s syndrome Rectus femoris strain/tear Adductor strain/tendonitis/tear Iliopsoas strain/tear Rectus abdominis strain/tear Muscle contusion Gracilis syndrome Snapping hip syndrome Neurologic Nerve entrapment: Ilioinguinal/obturator neuropathy Lumbar radiculopathy Other orthopaedic Bursitis Bone/soft tissue neoplasm of hip/pelvis Herniated nucleus pulposus Seronegative spondyloarthropathy Non-orthopaedic causes Hernia: Inguinal/femoral Gynecologic Endometriosis Pelvic inflammatory disease Ovarian cyst Gastrointestinal Rectal/colon neoplasm Inflammatory bowel disease Diverticulitis 6
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10/30/19
1
OAOS 2019 ● Portland, Oregon
Update on Hip ArthroscopyOAOS 2019
Lucas Korcek, MDEugene, Oregon
1
DisclosuresI have nothing to disclose
2
BackgroundHip arthroscopy continues to expand as a tool to address multiple hip pathologies
Many current practitioners were not exposed to hip arthroscopy in their formal training
3
Purpose• Overview: Many applications of hip arthroscopy in orthopedic surgery
• Focus: Femoral acetabular impingement (FAI) and labral tear treatment
4
Hip / Pelvic Pain: Diagnosis
Burnett JBJS 2006
21 months:Average time from injury
to accurate diagnosis
3.3:Average number of
providers seen before definitive treatment
5
6
Orthopaedic causes Bone/jointFemoroacetabular impingement (FAI) Acetabular labral tearsOsteitis pubisStress fractures: Pubic ramus/femoral neck Degenerative hip joint diseaseAvascular necrosis of the femoral head Slipped capital femoral epiphysisAvulsion fracture: ASIS/AIIS/Ischium