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Hip arthroscopy to remove loose bodies after traumatic dislocation
Brian H Mullis1, Laurence E Dahners
1Department of Orthopaedics, Florida Orthopaedic Institute, Tampa, FL, USA.
Objectives:
This study was designed to review the incidence of arthroscopically detected intra-articular loose bodies found in patients after traumatic hip dislocation or small acetabular wall fracture which would not otherwise be treated without surgery.
Design:
Retrospective review.
Setting:
Level 1 academic trauma center.
Patients:
Thirty-six patients who sustained traumatic hip injuries and subsequently had 39 hip arthroscopies between November 1997 and January 2004 were reviewed.
Intervention:
All patients had standard AP pelvis x-rays and CT scans performed. At our institution, patients with hip dislocations or acetabular wall fractures not otherwise requiring surgery are routinely offered hip arthroscopy to remove loose bodies. The radiographs were reviewed to determine incidence of loose bodies or nonconcentric reduction before hip arthroscopy. Chart review provided incidence of loose bodies found during arthroscopy.
Main Outcome Measurements:
Comparison was made between radiographic data obtained preoperatively and operative findings.
Results:
Loose bodies were found in the hips of 33 of 36 patients (92%) who were arthroscoped. Loose bodies were found in 7 of 9 cases (78%) in which standard radiographic studies (AP pelvis x-rays and CT scan) found no loose bodies and a concentric reduction.
Conclusions:
Loose bodies are routinely present after closed treatment of hip dislocations or wall fractures not otherwise requiring surgery, even when radiographs are negative. Hip arthroscopy may be indicated for loose body removal when open treatment is not otherwise necessary.
