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Arthroscopic hip preservation surgery practice patterns: an international survey
Kevin M Smith1, Brayden J Gerrie1, Patrick C McCulloch1
1Houston Methodist Orthopedics and Sports Medicine, 6550 Fannin Street, Smith Tower, Suite 2500, Houston, TX 77030, USA.
Journal of Hip Preservation Surgery
|June 21, 2017
Summary
Hip arthroscopy practices vary widely worldwide, with significant disagreements in pre-operative evaluation, intra-operative techniques, and post-operative management among experienced surgeons. Further high-quality research is needed to establish standardized protocols for hip arthroscopy.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Hip Arthroscopy
Background:
- Hip arthroscopy is a common procedure for hip joint issues.
- Standardized practice patterns for hip arthroscopy are not well-established globally.
Purpose of the Study:
- To analyze and report global practice patterns in pre-, intra-, and post-operative hip arthroscopy.
- To identify areas of consensus and discordance among hip arthroscopists worldwide.
Main Methods:
- A 21-question, IRB-exempt, HIPAA-compliant, cross-sectional survey was emailed to 151 international hip arthroscopists.
- Seventy-five experienced hip arthroscopists (8.6 years experience) completed the survey.
- Data analyzed practice patterns in patient evaluation, surgical techniques, and post-operative care.
Main Results:
- Radiographic imaging preferences included AP pelvis, false profile, and Dunn 45 views; 54% use CT scans.
- Most surgeons rarely perform arthroscopy for Tönnis grade 2-3 osteoarthritis (98%) or dysplasia (95%).
- Significant variation exists in capsular management (25% routine 'T' capsulotomy) and post-operative care (e.g., 52% never use a brace).
Conclusions:
- Global hip arthroscopy practices show considerable variation and lack of universal agreement in key areas.
- Experienced surgeons demonstrate discordant approaches to patient selection, surgical technique, and post-operative management.
- High-quality research is essential to develop evidence-based guidelines for hip arthroscopy procedures.
