Hip Joint Injuries

This session included presentations on: What’s the latest in femoroacetabular impingement; How accurate is radiology for cartilage and labrum?; Differences in management of females versus males with labral tears; Labral grafting; Articular cartilage injuries; and Rehabilitation after hip arthroscopy.

Femoroacetabular impingement (cam, pincer or mixed type) causes progressive damage to the soft tissues of the hip. The aim of surgical treatment, after appropriate patient selection, is to achieve an impingement free range of motion and to preserve and repair the labrum and capsule. MRI is accurate for imaging the labrum and cartilage but biochemical MRI techniques are useful for early disease detection. Hip labrum reconstruction is a new technique, using an ITB autograft or allograft, with promising short-term improvement in patient-reported outcome scores post-operatively. Regional cartilage lesions occur most frequently at acetabulum and early detection (by computer-enhanced-MRI or CT) and treatment is essential. Chondral flaps should be preserved if possible as they contain some living chondrocytes. In the repair of soft tissues, mechanical abnormalities need to be corrected also. As no two hips are the same, patient-specific rehab should start at the pre-op visit and strategies to avoid adhesions should be used early. A phased approach to the rehab continuum is advocated.