Revision Hip Arthroscopy

Overview

With the increasing number of hip arthroscopies performed worldwide comes an increasing need for revision hip arthroscopy. The reason for revision hip arthroscopy will vary from patient to patient. Some cases may be treated as a primary (first time) hip arthroscopy with more bony resection and labral repair or lysis of adhesions (breaking up scar tissue). However, other cases may require advanced surgical techniques that few surgeons perform. Dr. Shelton spent an additional year learning revision hip arthroscopy techniques from Dr. Marc Philippon at The Steadman Clinic in Vail, CO. 

In some cases, patients may require a graft of some sorts. If the labrum is there but small in size (< 6 mm) then an augmentation may be added or if the labrum is absent in an area then a reconstruction may be needed. These grafts are made using either iliotibial band autograft (from the patient) or allograft (from a cadaver) tissue. Another potential graft is a remplissage, which is used to fill a defect along the femoral neck if a patient had too much bone taken during a previous surgery. In this case, an iliotibial band allograft (from a cadaver) is typically used. These grafts will restore the suction seal of the hip joint. A third possible graft is a capsular reconstruction to help fill a defect in the capsule from a previous surgery. This technique generally uses an iliotibial band allograft (from a cadaver).  In some challenging cases, all 3 salvage grafts may be needed. 

Articles

• Labral Augmentation
• Labral Reconstruction
• Remplissage Survivorship
• Capsular Reconstruction Survivorship
• Terrible Triad

Potential Implications:

Blood loss, infection, damage to nerves or blood vessel including numbness over the lateral (side) of the thigh, possible post-operative fracture if weight bearing performed too soon, deep vein thrombosis (DVT), and need for additional surgery.