Skip to main content
Erschienen in: Clinical Orthopaedics and Related Research® 12/2012

01.12.2012 | Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery

Early Experience With a Comprehensive Hip Preservation Service Intended to Improve Clinical Care, Education, and Academic Productivity

verfasst von: Christopher L. Peters, MD, Stephen K. Aoki, MD, Jill A. Erickson, PA-C, Lucas A. Anderson, MD, Andrew E. Anderson, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 12/2012

Einloggen, um Zugang zu erhalten

Abstract

Background

The field of hip preservation surgery has grown substantially over the past decade. Although open hip procedures reportedly relieve pain and restore function, arthroscopic treatment has increasingly become a reasonable alternative. In 2008, we formed a comprehensive hip preservation service (HPS) to address clinical, educational, and research needs.

Questions/Purposes

We compared (1) volume, type, and corresponding improvement in pain and function of open and arthroscopic treatments; (2) orthopaedic resident test performance; and (3) academic productivity before and after creation of the HPS.

Methods

We retrospectively reviewed 212 patients undergoing 220 open procedures from 1996 to 2007 (Group 1) and 260 patients undergoing 298 procedures (153 open, 145 arthroscopic) from 2008 to May 2010 (Group 2). At each clinic visit, we recorded Harris hip score (HHS) and conversion to THA. Minimum followup was 1 year for Group 1 (mean, 4 years; range, 1–13 years) and Group 2 (mean, 1.5 years; range, 1–3 years). We compared orthopaedic resident performance on two standardized tests and the number of academic works (publications, book chapters, electronic media) and peer-reviewed grants funded before and after creation of the HPS.

Results

Mean HHS improved from 63 to 90 in Group 1 and from 76 to 91 in Group 2. Rate of conversion to THA was similar between groups despite expansion of surgical volume. Standardized orthopaedic resident test performance improved. Academic productivity as measured by publications and grant funding was facilitated by the HPS.

Conclusions

Early experience with a multidisciplinary HPS was positive; it facilitated clinical volume expansion while maintaining improvement in pain and function in young adults. Additional benefits included educational and academic productivity gains.

Level of Evidence

Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Aebi M, Richner L, Ganz R. [Long-term results of primary hip total prosthesis with acetabulum reinforcement ring] [in German]. Orthopade. 1989;18:504–510.PubMed Aebi M, Richner L, Ganz R. [Long-term results of primary hip total prosthesis with acetabulum reinforcement ring] [in German]. Orthopade. 1989;18:504–510.PubMed
2.
Zurück zum Zitat Anderson AE, Ellis BJ, Maas SA, Peters CL, Weiss JA. Validation of finite element predictions of cartilage contact pressure in the human hip joint. J Biomech Eng. 2008;130:051008.PubMedCrossRef Anderson AE, Ellis BJ, Maas SA, Peters CL, Weiss JA. Validation of finite element predictions of cartilage contact pressure in the human hip joint. J Biomech Eng. 2008;130:051008.PubMedCrossRef
3.
Zurück zum Zitat Anderson AE, Peters CL, Tuttle BD, Weiss JA. Subject-specific finite element model of the pelvis: development, validation and sensitivity studies. J Biomech Eng. 2005;127:364–373.PubMedCrossRef Anderson AE, Peters CL, Tuttle BD, Weiss JA. Subject-specific finite element model of the pelvis: development, validation and sensitivity studies. J Biomech Eng. 2005;127:364–373.PubMedCrossRef
4.
Zurück zum Zitat Anderson LA, Crofoot CD, Erickson J, Morton DA, Peters CL. Acetabular osteochondroplasty and simultaneous reorientation: background and validation of concept. Orthopedics. 2010;33. Anderson LA, Crofoot CD, Erickson J, Morton DA, Peters CL. Acetabular osteochondroplasty and simultaneous reorientation: background and validation of concept. Orthopedics. 2010;33.
5.
Zurück zum Zitat Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87:1012–1018.PubMedCrossRef Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87:1012–1018.PubMedCrossRef
6.
Zurück zum Zitat Bedi A, Zaltz I, De La Torre K, Kelly BT. Radiographic comparison of surgical hip dislocation and hip arthroscopy for treatment of cam deformity in femoroacetabular impingement. Am J Sports Med. 2011;39(suppl):20S–28S.PubMedCrossRef Bedi A, Zaltz I, De La Torre K, Kelly BT. Radiographic comparison of surgical hip dislocation and hip arthroscopy for treatment of cam deformity in femoroacetabular impingement. Am J Sports Med. 2011;39(suppl):20S–28S.PubMedCrossRef
7.
Zurück zum Zitat Byrd JW, Jones KS. Hip arthroscopy in athletes: 10-year follow-up. Am J Sports Med. 2009;37:2140–2143.PubMedCrossRef Byrd JW, Jones KS. Hip arthroscopy in athletes: 10-year follow-up. Am J Sports Med. 2009;37:2140–2143.PubMedCrossRef
8.
Zurück zum Zitat Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW. Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res. 2009;467:2041–2052.PubMedCrossRef Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW. Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res. 2009;467:2041–2052.PubMedCrossRef
9.
Zurück zum Zitat Ecker TM, Tannast M, Puls M, Siebenrock KA, Murphy SB. Pathomorphologic alterations predict presence or absence of hip osteoarthrosis. Clin Orthop Relat Res. 2007;465:46–52.PubMed Ecker TM, Tannast M, Puls M, Siebenrock KA, Murphy SB. Pathomorphologic alterations predict presence or absence of hip osteoarthrosis. Clin Orthop Relat Res. 2007;465:46–52.PubMed
10.
Zurück zum Zitat Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation: surgical technique. J Bone Joint Surg Am. 2007;89(pt 1 suppl 2):36–53.PubMedCrossRef Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation: surgical technique. J Bone Joint Surg Am. 2007;89(pt 1 suppl 2):36–53.PubMedCrossRef
11.
Zurück zum Zitat Fabricant PD, Heyworth BE, Kelly BT. Hip arthroscopy improves symptoms associated with FAI in selected adolescent athletes. Clin Orthop Relat Res. 2012;470:261–269.PubMedCrossRef Fabricant PD, Heyworth BE, Kelly BT. Hip arthroscopy improves symptoms associated with FAI in selected adolescent athletes. Clin Orthop Relat Res. 2012;470:261–269.PubMedCrossRef
12.
Zurück zum Zitat Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264–272.PubMedCrossRef Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466:264–272.PubMedCrossRef
13.
Zurück zum Zitat Graves M, Mast J. Femoroacetabular impingement: do outcomes reliably improve with surgical dislocations? Clin Orthop Relat Res. 2009;467:717–723.PubMedCrossRef Graves M, Mast J. Femoroacetabular impingement: do outcomes reliably improve with surgical dislocations? Clin Orthop Relat Res. 2009;467:717–723.PubMedCrossRef
14.
Zurück zum Zitat Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed
15.
Zurück zum Zitat Henak CR, Ellis BJ, Harris MD, Anderson AE, Peters CL, Weiss JA. Role of the acetabular labrum in load support across the hip joint. J Biomech. 2011;44:2201–2206.PubMedCrossRef Henak CR, Ellis BJ, Harris MD, Anderson AE, Peters CL, Weiss JA. Role of the acetabular labrum in load support across the hip joint. J Biomech. 2011;44:2201–2206.PubMedCrossRef
16.
Zurück zum Zitat Ilizaliturri VM Jr, Orozco-Rodriguez L, Acosta-Rodriguez E, Camacho-Galindo J. Arthroscopic treatment of cam-type femoroacetabular impingement preliminary report at 2 years minimum follow-up. J Arthroplasty. 2008;23:226–234.PubMedCrossRef Ilizaliturri VM Jr, Orozco-Rodriguez L, Acosta-Rodriguez E, Camacho-Galindo J. Arthroscopic treatment of cam-type femoroacetabular impingement preliminary report at 2 years minimum follow-up. J Arthroplasty. 2008;23:226–234.PubMedCrossRef
17.
Zurück zum Zitat Kamath AF, Componovo R, Baldwin K, Israelite CL, Nelson CL. Hip arthroscopy for labral tears: review of clinical outcomes with 4.8-year mean follow-up. Am J Sports Med. 2009;37:1721–1727.PubMedCrossRef Kamath AF, Componovo R, Baldwin K, Israelite CL, Nelson CL. Hip arthroscopy for labral tears: review of clinical outcomes with 4.8-year mean follow-up. Am J Sports Med. 2009;37:1721–1727.PubMedCrossRef
18.
Zurück zum Zitat Kavanagh BF, Ilstrup DM, Fitzgerald RH Jr. Revision total hip arthroplasty. J Bone Joint Surg Am. 1985;67:517–526.PubMed Kavanagh BF, Ilstrup DM, Fitzgerald RH Jr. Revision total hip arthroplasty. J Bone Joint Surg Am. 1985;67:517–526.PubMed
19.
Zurück zum Zitat Kohnlein W, Ganz R, Impellizzeri FM, Leunig M. Acetabular morphology: implications for joint-preserving surgery. Clin Orthop Relat Res. 2009;467:682–691.PubMedCrossRef Kohnlein W, Ganz R, Impellizzeri FM, Leunig M. Acetabular morphology: implications for joint-preserving surgery. Clin Orthop Relat Res. 2009;467:682–691.PubMedCrossRef
20.
Zurück zum Zitat Larson CM, Giveans MR. Arthroscopic management of femoroacetabular impingement: early outcomes measures. Arthroscopy. 2008;24:540–546.PubMedCrossRef Larson CM, Giveans MR. Arthroscopic management of femoroacetabular impingement: early outcomes measures. Arthroscopy. 2008;24:540–546.PubMedCrossRef
21.
Zurück zum Zitat Leunig M, Beaule PE, Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res. 2009;467:616–622.PubMedCrossRef Leunig M, Beaule PE, Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res. 2009;467:616–622.PubMedCrossRef
22.
Zurück zum Zitat Leunig M, Huff TW, Ganz R. Femoroacetabular impingement: treatment of the acetabular side. Instr Course lect. 2009;58:223–229.PubMed Leunig M, Huff TW, Ganz R. Femoroacetabular impingement: treatment of the acetabular side. Instr Course lect. 2009;58:223–229.PubMed
23.
Zurück zum Zitat Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M. Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome. J Bone Joint Surg Am. 2009;91:2113–2123.PubMedCrossRef Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M. Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome. J Bone Joint Surg Am. 2009;91:2113–2123.PubMedCrossRef
24.
Zurück zum Zitat McCarthy JC, Jarrett BT, Ojeifo O, Lee JA, Bragdon CR. What factors influence long-term survivorship after hip arthroscopy? Clin Orthop Relat Res. 2011;469:362–371.PubMedCrossRef McCarthy JC, Jarrett BT, Ojeifo O, Lee JA, Bragdon CR. What factors influence long-term survivorship after hip arthroscopy? Clin Orthop Relat Res. 2011;469:362–371.PubMedCrossRef
25.
Zurück zum Zitat Parvizi J, Leunig M, Ganz R. Femoroacetabular impingement. J Am Acad Orthop Surg. 2007;15:561–570.PubMed Parvizi J, Leunig M, Ganz R. Femoroacetabular impingement. J Am Acad Orthop Surg. 2007;15:561–570.PubMed
26.
Zurück zum Zitat Peters CL, Anderson LA, Erickson JA, Anderson AE, Weiss JA. An algorithmic approach to surgical decision making in acetabular retroversion. Orthopedics. 2011;34:10.PubMed Peters CL, Anderson LA, Erickson JA, Anderson AE, Weiss JA. An algorithmic approach to surgical decision making in acetabular retroversion. Orthopedics. 2011;34:10.PubMed
27.
Zurück zum Zitat Peters CL, Erickson JA, Anderson L, Anderson AA, Weiss J. Hip-preserving surgery: understanding complex pathomorphology. J Bone Joint Surg Am. 2009;91(suppl 6):42–58.PubMedCrossRef Peters CL, Erickson JA, Anderson L, Anderson AA, Weiss J. Hip-preserving surgery: understanding complex pathomorphology. J Bone Joint Surg Am. 2009;91(suppl 6):42–58.PubMedCrossRef
28.
Zurück zum Zitat Peters CL, Erickson JA, Hines JL. Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am. 2006;88:1920–1926.PubMedCrossRef Peters CL, Erickson JA, Hines JL. Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am. 2006;88:1920–1926.PubMedCrossRef
29.
Zurück zum Zitat Peters CL, Schabel K, Anderson L, Erickson J. Open treatment of femoroacetabular impingement is associated with clinical improvement and low complication rate at short-term follow-up. Clin Orthop Relat Res. 2010;468:504–510.PubMedCrossRef Peters CL, Schabel K, Anderson L, Erickson J. Open treatment of femoroacetabular impingement is associated with clinical improvement and low complication rate at short-term follow-up. Clin Orthop Relat Res. 2010;468:504–510.PubMedCrossRef
30.
Zurück zum Zitat Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Am. 2009;91:16–23.CrossRef Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Am. 2009;91:16–23.CrossRef
31.
Zurück zum Zitat Philippon MJ, Wolff AB, Briggs KK, Zehms CT, Kuppersmith DA. Acetabular rim reduction for the treatment of femoroacetabular impingement correlates with preoperative and postoperative center-edge angle. Arthroscopy. 2010;26:757–761.PubMedCrossRef Philippon MJ, Wolff AB, Briggs KK, Zehms CT, Kuppersmith DA. Acetabular rim reduction for the treatment of femoroacetabular impingement correlates with preoperative and postoperative center-edge angle. Arthroscopy. 2010;26:757–761.PubMedCrossRef
32.
Zurück zum Zitat Scher DL, Belmont PJ Jr, Owens BD. Case report: osteonecrosis of the femoral head after hip arthroscopy. Clin Orthop Relat Res. 2010;468:3121–3125.PubMedCrossRef Scher DL, Belmont PJ Jr, Owens BD. Case report: osteonecrosis of the femoral head after hip arthroscopy. Clin Orthop Relat Res. 2010;468:3121–3125.PubMedCrossRef
33.
Zurück zum Zitat Shearer DW, Kramer J, Bozic KJ, Feeley BT. Is hip arthroscopy cost-effective for femoroacetabular impingement? Clin Orthop Relat Res. 2012;470:1079–1089.PubMedCrossRef Shearer DW, Kramer J, Bozic KJ, Feeley BT. Is hip arthroscopy cost-effective for femoroacetabular impingement? Clin Orthop Relat Res. 2012;470:1079–1089.PubMedCrossRef
34.
Zurück zum Zitat Sink EL, Beaule PE, Sucato D, Kim YJ, Millis MB, Dayton M, Trousdale RT, Sierra RJ, Zaltz I, Schoenecker P, Monreal A, Clohisy J. Multicenter study of complications following surgical dislocation of the hip. J Bone Joint Surg Am. 2011;93:1132–1136.PubMedCrossRef Sink EL, Beaule PE, Sucato D, Kim YJ, Millis MB, Dayton M, Trousdale RT, Sierra RJ, Zaltz I, Schoenecker P, Monreal A, Clohisy J. Multicenter study of complications following surgical dislocation of the hip. J Bone Joint Surg Am. 2011;93:1132–1136.PubMedCrossRef
35.
Zurück zum Zitat Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year follow-up of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466:1633–1644.PubMedCrossRef Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year follow-up of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466:1633–1644.PubMedCrossRef
36.
Zurück zum Zitat Steppacher SD, Tannast M, Werlen S, Siebenrock KA. Femoral morphology differs between deficient and excessive acetabular coverage. Clin Orthop Relat Res. 2008;466:782–790.PubMedCrossRef Steppacher SD, Tannast M, Werlen S, Siebenrock KA. Femoral morphology differs between deficient and excessive acetabular coverage. Clin Orthop Relat Res. 2008;466:782–790.PubMedCrossRef
Metadaten
Titel
Early Experience With a Comprehensive Hip Preservation Service Intended to Improve Clinical Care, Education, and Academic Productivity
verfasst von
Christopher L. Peters, MD
Stephen K. Aoki, MD
Jill A. Erickson, PA-C
Lucas A. Anderson, MD
Andrew E. Anderson, PhD
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 12/2012
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2549-3

Weitere Artikel der Ausgabe 12/2012

Clinical Orthopaedics and Related Research® 12/2012 Zur Ausgabe

Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery

Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.