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Mixed femoroacetabular impingement (FAI) is typically managed with both femoral and acetabular rim osteoplasties, but it has not been reported if the rim osteoplasty is always required. We hypothesized that mixed FAI managed by femoral or combined femoral and acetabular osteoplasties will both attain satisfactory clinical results, provided intraoperative impingement-free functional motion is attained.
Is intraarticular pathology common in patients with hip dysplasia undergoing periacetabular osteotomy?
Periacetabular osteotomy (PAO) enables correction of bony acetabular deficiency in the setting of hip dysplasia. Patients with insufficient acetabular coverage often have intraarticular pathology, but the degree of this pathology has been incompletely characterized. We have used arthroscopy as an adjunct to PAO to further delineate intraarticular pathology in patients with hip dysplasia with mechanical symptoms.
Combined hip arthroscopy and periacetabular osteotomy: indications, advantages, technique, and complications.
Evaluation and treatment of concomitant intra-articular pathology may be beneficial before periacetabular osteotomy (PAO) is performed. Hip arthroscopy before PAO allows the surgeon to perform full inspection of the hip joint and can be used to treat hip pathology before osteotomy. The indications for hip arthroscopy before PAO are presented in this article. The combined surgical procedure is described, along with potential complications. The advantages and disadvantages of this technique are outlined.
Periacetabular osteotomy and arthroscopic labral repair after failed hip arthroscopy due to iatrogenic aggravation of hip dysplasia.
Hip arthroscopy can be a successful surgery when properly indicated and performed properly. In the setting of dysplasia, arthroscopy of the hip can lead to devastating consequences. This case presents a patient who underwent hip arthroscopy despite having significant hip dysplasia. The surgery failed and was subsequently revised with a concomitant arthroscopic labral repair and periacetabular osteotomy with good results at 2-year follow-up.
Complications of femoral nerve blockade in total knee arthroplasty and strategies to reduce patient risk.
Femoral nerve catheters are widely used for analgesia in total knee arthroplasty. Although evidence suggests that catheters improve pain control and may facilitate short-term rehabilitation, few reports exist regarding their complications. This case series explores the experience of femoral nerve catheter use at high-volume orthopedic specialty hospitals. Serious complications including compartment syndrome, periprosthetic fracture, and vascular injury are reported. The authors support femoral nerve catheter use with appropriate precautions taken to reduce risk of patient falls, vascular injury, and wrong-site surgery.