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Background: Studies on midterm outcomes of the arthroscopic treatment of femoroacetabular impingement (FAI) and labral tears with mild osteoarthritis (OA) are limited. Purpose: To evaluate outcomes of the arthroscopic treatment of FAI and labral tears in patients with mild preoperative OA (Tönnis grade 1) at a minimum 5-year follow-up, and to perform a matched-pair comparison to a control group with Tönnis grade 0. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected on patients who underwent hip arthroscopic surgery between February 2008 and April 2011. Inclusion criteria were arthroscopic treatment for FAI and labral tears and having preoperative patient-reported outcome (PRO) scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) scores for pain. Exclusion criteria were workers’ compensation claims, preoperative Tönnis grade ≥2, and previous hip conditions (ipsilateral surgery, slipped capital femoral epiphysis, avascular necrosis, and dysplasia). Patients with minimum 5-year outcomes were eligible for matching on a 1:1 ratio (Tönnis grade 0 vs 1) based on age ±5 years, body mass index ±5 kg/m2, sex, labral treatment, and capsular treatment. Results: Of 356 eligible hips, 292 hips had minimum 5-year outcomes (82%). Eighty-five hips with Tönnis grade 1 were evaluated. At 5-year follow-up, patients with Tönnis grade 1 had significant improvements in all PRO and VAS scores (P < .0001). The overall satisfaction score was 8.2. The survivorship rate with respect to conversion to total hip arthroplasty for the Tönnis grade 1 group was 69.4% at 5 years, while in the Tönnis grade 0 group, it was 88.4% (P = .0002). Sixty-two hips with Tönnis grade 0 were matched to 62 hips with Tönnis grade 1. Both groups demonstrated improvements in all PRO and VAS scores from preoperatively to postoperatively (P < .0001). No significant differences existed between preoperative or postoperative scores or survivorship between the groups. Conclusion: The arthroscopic treatment of FAI and labral tears in patients with Tönnis grade 1 had good results at 5-year follow-up. After controlling for other variables using a matched-pair comparison, patients with Tönnis grade 1 had similar, durable improvements to those with Tönnis grade 0. While strict surgical indications and appropriate expectations are recommended for patients with mild OA, Tönnis grade 1 alone should not be considered a contraindication to hip arthroscopic surgery. [ABSTRACT FROM AUTHOR]

Background: Pathologic changes of the long head of the biceps tendon are a recognized source of shoulder pain in adults that can be treated with tenotomy or tenodesis when nonoperative measures are not effective. It is not clear whether arthroscopic or open biceps tenodesis has a clinical advantage. Hypothesis: Pain relief and shoulder function after all-arthroscopic suprapectoral biceps tenodesis are similar to outcomes after an open subpectoral tenodesis. Study Design: Cohort study; Level of evidence, 3. Methods: A prospective database was reviewed for patients undergoing an all-arthroscopic suprapectoral or open subpectoral biceps tenodesis. Adult patients with a minimum 18-month follow-up were included. Patients undergoing a concomitant rotator cuff or labral repair were excluded. The groups were matched to age within 3 years, sex, and time to follow-up within 3 months. Pain improvement, development of a ‘‘Popeye’’ deformity, muscle cramping, postoperative American Shoulder and Elbow Surgeons scores, satisfaction scores, and complications were evaluated. Results: Forty-six patients (23 all-arthroscopic, 23 open) with an average age of 57.2 years (range, 45-70 years) were evaluated at a mean follow-up of 30.1 months (range, 21.1-44.9 months). No patients in either group developed a Popeye deformity or complained of arm cramping. There was no significant difference in mean American Shoulder and Elbow Surgeons scores between the open and all-arthroscopic groups (92.3 vs 88.9; P = .42); similarly, there was no significant difference in patient satisfaction scores between the groups (8.9 vs 9.1; P = .73). Eighteen patients (78.3%) in the arthroscopic cohort and 16 (69.6%) in the open cohort fully returned to athletic activity (P = .50). Eight patients (34.8%) in the arthroscopic group and 10 (39.1%) in the open group reported pain at night or with heavy activities. There were no complications in the all-arthroscopic group. There were 2 complications in the open group that resolved by final follow-up. Conclusion: Biceps tenodesis remains a reliable treatment for pathologic abnormality of the long head of the biceps. Patients undergoing an all-arthroscopic suprapectoral tenodesis in the distal aspect or distal to the bicipital groove showed similar pain relief and clinical outcomes as compared with patients undergoing open subpectoral tenodesis. Open subpectoral biceps tenodesis may carry a higher complication risk secondary to a more invasive technique. [ABSTRACT FROM AUTHOR]

This article discusses a study which evaluated clinical outcomes in a cohort of patients with borderline dysplasia who were treated with arthroscopic labral preservation and capsular plication. Between April 2008 and November 2010, the researchers examined patients who underwent hip arthroscopy for symptomatic intra-articular hip disorders. They learned that patients with borderline dysplasia have often fallen into a gray area between arthroscopy and periacetabular osteotomy.

The article presents a study on hip arthroscopy for labral tears among patients receiving workers' compensation (WC) with those of a matched group not receiving WC. Data were collected on all patients treated with hip arthroscopy in June 2008 to August 2010. Results show patients with WC status had significantly lower preoperative patient-reported outcome (PRO) scores for all measures. The authors say there was no significant difference between visual analog scale (VAS) scores of the groups.

The article discusses the study of early outcomes of endoscopic repair of partial and full-thickness gluteus medius tears. It states that gluteus medius tears can transmit functional impairment causing chronic peritrochanteric hip pain. It reveals the satisfactory scores of all hip specific surgery with postoperative improvement. Endoscopic surgical repair performed through fullthickness technique, is an effective treatment of gluteus medius tears of minimum 2 years follow-up is also concluded.

Background: The ligamentum teres (LT) anatomy has been known for many years. While its functionality remains debatable, it is well recognized that the LT can be a source of pain in the hip joint. In 1997, a landmark publication by Gray and Villar established a classification for LT tears and increased the awareness of LT disorders. However, the incidence of LT tears and the various tear types is unknown.Purpose: The authors report the prevalence of LT tears in a population of patients who underwent hip arthroscopy, using both the Gray and Villar classification and a new descriptive classification.Study Design: Case series; Level of evidence, 4.Methods: Between February 2008 and January 2011, 616 hip arthroscopies were performed by the senior author. After excluding revision surgeries, a total of 558 surgeries (502 patients) were included in the study. Data were collected regarding patients’ demographics, mechanism of injury, range of motion, magnetic resonance results, and intraoperative findings. Preoperative hip-specific questionnaire scores and pain level were recorded as well. Ligamentum teres tears were classified according to Gray and Villar’s classification, and were also categorized using a descriptive grading system as follows: 0, no tear; 1, <50% tear; 2, >50% tear; or 3, 100% tear.Results: A total of 284 (51%) of the 558 surgeries in this cohort revealed LT tears. According to the descriptive grading system, 22% were grade 1, 24% were grade 2, and 5% were grade 3. According to the Gray and Villar classification 3.7% had full rupture, 43% had a partial tear, and 4.5% had a degenerative tear. Patients with LT tears were significantly older and had worse preoperative functional scores; they did, however, have a greater range of motion. Intraoperatively, an association with larger labral tear size and acetabular chondral damage was found. Magnetic resonance arthrography was found to have low accuracy and sensitivity in detection of LT tears. No correlation to the pain level was found.Conclusion: Ligamentum teres tears had a higher prevalence in this study than was published in the past, most probably attributable to a lower threshold used in defining a tear. The incidence is defined both using the Gray and Villar classification, as well as a new descriptive classification system that categorizes the LT according to amount of tearing. [ABSTRACT FROM AUTHOR]