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The current study aimed to assess the efficacy of two unlike laser wavelengths (655 nm and 808 nm) used as photobiomodulation or low-level laser therapy (LLLT) on the immune status in male rats. Sixty-five male Sprague–Dawley rats were considered in the experiments which were further divided into three groups. For all the three groups, LPS (lipopolysaccharide) was used as an immunostimulant and it was administered 5mg/kg via intraperitonially (ip) route for 3 consecutive days. In the first group, 655 nm LLLT (power 150 mW) was investigated against LPS induced immune response. Second group investigated 808 nm LLLT (power 150 mW) against LPS induced immune function. After finding out the better responsive LLLT, third group investigated 808 nm LLLT with different power ie 75 mW and 150 mW. The results indicated that 655 nm LLLT at 150 mW power was not restored LPS associated TNF-α and IL-1β content. While, LPS induced enhance IL-1β and TNF-α level was significantly decreased in 808 nm LLLT group. Further, comparison was studied in 808 nm LLLT at different power ie 150 mW and 75 mW and pro-inflammatory cytokines estimation was quantified. The outcome of the study concluded that 808 nm LLLT has anti-inflammatory activity at 150 mW power. Hence, the further research work is required in this direction to advise that 808 nm LLLT at 150 mW could be considered as a treatment to protect inflammatory diseases. Keywords: Photobiomodulation; low-level laser therapy (LLLT); immune status; 655nm; 808nm; in vivo

Purpose The purpose of this study is to identify the needs and concerns of older people in Jaipur, Rajasthan, India during the lockdown phase of the Covid-19 crisis. The study also aims to present a viable model for extending needed support through a telephone helpline run by a team of young student volunteers. Design/methodology/approach The study uses a thematic analysis of the interaction between callers (service users) and volunteers. Findings The study shows that the main reasons that motivate the use of the helpline are to seek medical advice and to request medical services and medical supplies free of charge. However, the study also shows that other reasons for calling the helpline are feelings of loneliness and the need for psychological support, especially due to insufficient assistance from families. Practical implications The study shows the benefits of providing this type of service for older people during a time of national health crisis. The service is cost-effective and offers a one-stop assistance point. Social implications The service also constitutes an avenue for building intergenerational solidarity and empathy between younger and older people. This is especially important for citizens who feel socially isolated and disconnected from the rest of society. Originality/value The study offers a model for an easily created resource that could usefully be exported to other geographic settings.

Treatment of non-healing burn injuries is a major challenge for the current scientific research. Hydrogen sulfide (H2S) is an endogenous gasotransmitter, which regulates redox homeostasis and cytoprotection during pathophysiological conditions. Similarly, heat shock proteins (HSPs) are molecular chaperones, which also confer cytoprotection during the wound repair process. Notably, the role of H2S as a regulator of HSPs during burn wound healing is still elusive. The present study investigated the effects of H2S supplementation on molecular chaperones during full-thickness, third-degree burn wound healing in the experimental rats. The animals were treated with sodium hydrosulphide (NaHS) as H2S donor (5 mg/kg body weight, intraperitoneal) daily for 10 days prior to burn-induction and continued till the fifth-day post-wounding. Histopathological analysis (Masson’s trichrome) revealed enhanced wound healing evident by increased collagen fiber deposition, cellular proliferation and re-epithelialisation in NaHS administered group as compared to the burn control. Furthermore, immunoblot analyses demonstrated significantly increased protein expression of molecular chaperons viz. HSP90, HSP70, HSP27, and GRP78 in H2S treated group as compared to control. Therefore, the present study signifies that H2S supplementation upregulates the protein expression levels of molecular chaperones, which could facilitate the cytoprotection during the tissue repair process and accelerates the burn wound healing.

Hip arthroscopy for femoral and acetabular pathologies has increased dramatically. However, there is little literature analyzing procedures as predictors of revision arthroscopy or arthroplasty. From February 2008 to November 2015, patients undergoing hip arthroscopy for a labral tear with minimum 2-year follow-up and between 18 and 60 years old were retrospectively reviewed. Those with previous surgeries, Tönnis grade greater than 1, and previous hip conditions were excluded. Follow-up was obtained for 1118 patients (1249 hips; 81.7%) with a mean age of 38.7 years (range, 18.0–60.0 years), mean body mass index of 26.4 kg/m 2 (range, 16.3–48.9 kg/m 2 ), and mean follow-up of 50.2 months (range, 24.0–111.9 months). A total of 122 (9.8%) patients converted to total hip arthroplasty (mean, 35.3 months; range, 1.4–95.2 months). Multivariate analysis for predictors of total hip arthroplasty found age at surgery (hazard ratio, 1.064/y; P P P =.03), and notchplasty (HR, 2.128; P P P P P =.04) to be significant, with age at date of surgery (HR, 0.973/y; P P =.05) associated with higher survivorship. Understanding risk factors for conversion to total hip arthroplasty or revision is paramount during discussions with patients. [ Orthopedics . 2020;43(3):173–181.]

The management of multifaceted burn wound imparts a huge health care burden. Innumerable complexities associated with non-healing burn wounds led to the search for new therapeutic healing modalities. Earlier, our studies have shown that photobiomodulation (PBM) with superpulsed 904 nm laser increased cellular proliferation, bioenergetics activation, reduced inflammation and nitroxidative stress during burn wound healing. Coenzyme Q10 (CoQ10), a mitochondrial electron carrier acts as a potent antioxidant, maintains redox balance and mitochondrial dysfunction. Multi-target therapy aims to accelerate healing of intractable impaired wounds, which could exhibit a synergistic effect to potentially affecting different phases of the repair process. The present study investigates the efficacy of 904 nm superpulsed laser-mediated PBM (200 ns pulse-width, 100 Hz frequency, 0.24 J/cm2 total energy density, 0.40 mW/cm2 average power density and 19.77 W/cm2 peak power density for 10 min once daily for 7 days post-wounding) and CoQ10 (0.6%, w/v) topical treatments individually and in combination on full-thickness burn wound healing in rats and further explore the underlying mechanisms of action. The dual treatment showed significant (p

Microwave (MW) radiation poses the risk of potential hazards on human health. The present study investigated the effects of MW 10 GHz exposure for 3 h/day for 30 days at power densities of 5.23 ± 0.25 and 10.01 ± 0.15 mW/cm2 in the skin of rats. The animals exposed to 10 mW/cm2 (corresponded to twice the ICNIRP-2020 occupational reference level of MW exposure for humans) exhibited significant biophysical, biochemical, molecular and histological alterations compared to sham-irradiated animals. Infrared thermography revealed an increase in average skin surface temperature by 1.8°C and standard deviation of 0.3°C after 30 days of 10 mW/cm2 MW exposure compared to the sham-irradiated animals. MW exposure also led to oxidative stress (ROS, 4-HNE, LPO, AOPP), inflammatory responses (NFkB, iNOS/NOS2, COX-2) and metabolic alterations [hexokinase (HK), lactate dehydrogenase (LDH), citrate synthase (CS) and glucose-6-phospahte dehydrogenase (G6PD)] in 10 mW/cm2 irradiated rat skin. A significant alteration in expression of markers associated with cell survival (Akt/PKB) and HSP27/p38MAPK-related stress-response signaling cascade was observed in 10 mW/cm2 irradiated rat skin compared to sham-irradiated rat skin. However, MW-irradiated groups did not show apoptosis, evident by unchanged caspase-3 levels. Histopathological analysis revealed a mild cytoarchitectural alteration in epidermal layer and slight aggregation of leukocytes in 10 mW/cm2 irradiated rat skin. Altogether, the present findings demonstrated that 10 GHz exposure in continuous-wave mode at 10 mW/cm2 (3 h/day, 30 days) led to significant alterations in molecular markers associated with adaptive stress-response in rat skin. Furthermore, systematic scientific studies on more prevalent pulsed-mode of MW-radiation exposure for prolonged duration are warranted.

BACKGROUND AND OBJECTIVES Dysregulated inflammation is one of the major contributing factors for the prevalence of non-healing chronic wound in immunosuppressed subjects. Photobiomodulation (PBM) has emerged as a potential non-thermal, light-based therapeutic healing intervention for the treatment of impaired wounds. STUDY DESIGN/MATERIALS AND METHODS The present study delineates the underlying molecular mechanisms of PBM 810 nm laser-induced full-thickness cutaneous wound repair in immunosuppressed rats at continuous and pulsed wave-mode with power-density of 40 mW/cm 2 , fluence 22.6 J/cm 2 for 10 minutes daily for 7 post-wounding days. Molecular markers were assessed using biochemical, enzyme-linked immunosorbent assay quantification, enzyme kinetics and immunoblots analyses pertaining to inflammation, oxidative stress, cell survival, calcium signaling, and proliferation cascades. RESULTS Results distinctly revealed that pulsed 810 nm (10 Hz) PBM potentially influenced the cell survival and proliferation signaling pathway by significantly upregulated phospho-protein kinase B(phospho-Akt), phospho-extracellular-signal-regulated kinase 1 (ERK1), transient receptor potential vanilloid-3 (TRPV3), Ca2+ , calmodulin, transforming growth factor-β1 (TGF-β1), TGF-βR3, and Na + /K + -ATPase pump levels. PBM treatment resulted in reduction of exaggerated inflammatory responses evident by significantly repressed levels of interleukin-1β (IL-1β), IL-6, cyclooxygenase 2 (COX-2), and substance-P receptor (SPR), as well as inhibited apoptotic cell death by decreasing p53, cytochrome C, and caspase 3 levels (P

Rapid advancement of radiofrequency (RF)-driven technologies has greatly affected our everyday lives. Increasing evidence led by in-vitro, in-vivo studies, epidemiological and clinical trials indicates that RF interacts considerably well with biological systems in various ways depending on different exposure parameters and properties of biological materials. Besides their innumerable benefits in different sectors of commercial and military fields, they can induce alterations in many physiological functions of the body, which may culminate into adverse human health consequences. The present article explicitly addresses the RF-based technologies and their applications, fundamentals of RF energy interaction with biological systems, exposure parameters, and dosimetry studies along with thermal and non-thermal effects on different vital organs at molecular and cellular levels. Further, this article outlines the limitations of RF-induced biological effect studies, status of risk assessment, safety levels and its future perspectives.

In this paper, The gate-material engineering technique is used on double gate all around (DGAA) MOSFET. The gate material engineering technique has two dissimilar materials with dissimilar work functions. The different materials have combined to make a single gate MOSFET. The silicon-tube double-gate-all-around MOSFET have two gates. There are one gate (inner gate) inside of silicon-tube and one gate (outer gate) outside of silicon-tube. ATLAS device simulation based comparative study of double material double gate all around (DMDGAA) and double gate all around (DGAA) Junction based MOSFETs have been performed. The simulation results express that this modification of MOSFET enhanced the ON-OFF current (I ON /I OFF ) ratio, greatly reduce the OFF current (I OFF ). The introduced modification also improves short channel effects (SCEs) compared to DGAA MOSFET. DMDGAA MOSFET provides high-speed and ultra-low power operation for Ultra large-scale integration (ULSI) applications.

Nanotechnology has given the opportunity to the researcher for developing new nano-composites in all field including, pharmaceuticals, agriculture, electronics and other fields. In this study agriculture waste material like bagasse dust has been combined with polyaniline to prepare new Nano composites. So formed Nano composite was characterised by using XRD, FTIR and SEM. SEM confirmed the Nanocomposite formation with size in the range of 100-130 nm. Such nanocomposites were used in the removal of dyes and heavy metals from industrial effluent. About 80-99% heavy metals could be removed through adsorption successfully.

Burn wound is a complex multi-factorial pathophysiology producing excruciating pain and psychological discomfort among patients, which imposes a major burden on the healthcare system. Multi-target therapy focuses on augmented healing by regulating different phases of tissue repair. Recently, photobiomodulation (PBM)-induced wound healing has achieved profound impetus as a non-invasive, drug-free biophysical therapeutic approach. On the other hand, medicinal honey known to possess antibacterial and immunomodulatory properties and is being used as an effective treatment option for infected wounds. The present study aimed to determine whether the combination of medicinal honey and PBM using superpulsed 904 nm laser treatment could additively accelerate full-thickness burn wound repair in rats. Animals were randomly allocated into 4 experimental groups: control (C), PBM superpulsed 904 nm laser treated (PBMT), honey treated (HT) and combined treatment (CT). The dual treatment exhibited an enhanced wound area contraction and hexosamine content as compared to the other groups. Histopathological analysis revealed increased cellular proliferation, extracellular matrix accumulation and decreased inflammation in the CT group. Further, the CT group demonstrated synergistically attenuated inflammation, pain and enhanced cell adhesion, migration as evidenced by significantly reduced protein expression of TNF-α, NF-κB, IL-1β, COX-2, substance-P receptor and up-regulation of fibronectin, respectively as compared with the other groups. Thus, the findings of present study signify that the combination of medicinal honey and PBMT accelerates the repair process of burn wounds. The study showed that therapeutic efficacy of 904 nm superpulsed laser-mediated PBM augments in the presence of medicinal honey by enhancing cellular proliferation and attenuation of inflammation and pain in burn wound healing.

Phototherapy or light-based treatment is emerging as a very promising biophysical, non-invasive or minimal invasive and non-traumatic healing modality. It includes photobiomodulation (PBM) therapy and photodynamic therapy (PDT). PBM involves irradiation of injured tissue with photons mostly in the red and near-infrared region at relatively low-intensity (non-thermal). This light absorption causes photophysical and photochemical reactions, which in turn sets in various biological events like stimulation of cell growth, attenuation of inflammation, pain and recovery from damage. PDT makes use of photoactivated dye known as photosensitizer to kill multi-drug resistant microorganisms and cancer cells. Apart from investigations on their therapeutic efficacy, a lot of work is being carried out to generate a better understanding of the mechanisms of action of light-based therapy at the cellular and molecular levels, and downstream effector molecules. The present article provides a brief overview of the activity in this field with emphasis on the work carried out in the country.

Failure of hip preservation to alleviate symptoms potentially subjects the patient to reoperation or conversion surgery to THA, adding recovery time, risk, and cost. A risk calculator using an algorithm that can predict the likelihood that a patient who undergoes arthroscopic hip surgery will undergo THA within 2 years would be helpful, but to our knowledge, no such tool exists. (1) Are there preoperative and intraoperative variables at the time of hip arthroscopy associated with subsequent conversion to THA? (2) Can these variables be used to develop a predictive tool for conversion to THA? All patients undergoing arthroscopy from January 2009 through December 2011 were registered in our longitudinal database. Inclusion criteria for the study group were patients undergoing hip arthroscopy for a labral tear, who eventually had conversion surgery to THA. Patients were compared with a control group of patients who underwent hip arthroscopy for a labral tear but who did not undergo conversion surgery to THA during the same study period. Of the 893 who underwent surgery during that time, 792 (88.7%) were available for followup at a minimum of 2 years (mean, 31.1 ± 8.1 years) and so were considered in this analysis. Multivariate regression analyses of 41 preoperative and intraoperative variables were performed. Using the results of the multivariate regression, we developed a simplified calculator that may be helpful in counseling a patient regarding the risk of conversion to THA after hip arthroscopy. Variables simultaneously associated with conversion to THA in this model were older age (rate ratio, 1.06; 95% CI, 1.03–1.08; p

To evaluate femoral head-neck bone regrowth and PROs in skeletally immature patients that underwent arthroscopic femoroplasties over a minimum 2-year period.Eleven skeletally immature hips (10 patients) with open femoral head physes underwent femoroplasty between October 2008 and November 2013. Inclusion criteria were minimum 2-year follow-up with patient-reported outcomes (PROs) and radiographs preoperatively, at 2 weeks, and at a minimum of 2 years postoperatively. Exclusion criteria were16 years of age, preoperative Tönnis grade1 and previous hip conditions. Preoperative radiographs were used to assess skeletal immaturity, which was indicated by a Risser score ≤4 and femoral head physis1 mm. Alpha angles were measured preoperatively, at 2 weeks, and at a minimum of 2 years postoperatively. PROs, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and visual analog scale (VAS) score, were measured preoperatively and at the latest follow-up.Mean age at surgery was 14.7 years (range: 13.2-15.9). Mean follow-up was 35.7 months (range: 23.3-61.4). All hips tested positive for anterior impingement preoperatively. The mean preoperative alpha angle was 61.8°, which decreased to 41.5° postoperatively (P.0001) and was 40.7° at a minimum of 2 years postoperatively. No bony regrowth was documented at the latest follow-up. Mean improvements in scores were as follows: mHHS = 58.5 to 79.8 (P.0001), NAHS = 56.8 to 87.1 (P = .008), HOS-SSS = 34.3 to 78.3 (P = .004), and VAS score = 7.5 to 1.3 (P .0001). Mean patient satisfaction was 8.7 ± 1.7. One hip (9.0%) required revision arthroscopy at 31.1 months. No postoperative complications were reported.Bony regrowth of the femoral head-neck region did not occur in this study of skeletally immature females who underwent arthroscopic femoroplasty. In this group of patients, hip arthroscopic treatment of FAI and labral tears is a safe and favorable intervention because of its high patient satisfaction and outcome scores and absence of postoperative complications.Level IV, prognostic study.

Summary The innumerable intricacies associated with chronic wounds have made the development of new painless, noninvasive, biophysical therapeutic interventions as the focus of current biomedical research. Red and near-infrared light-induced photobiomodulation therapy appears to emerge as a promising drug-free approach for promoting wound healing, reduction in inflammation, pain and restoration of function owing to penetration power in conjunction with their ability to positively modulate the biochemical and molecular responses. This review will describe the physical properties of red and near-infrared light and their interaction with skin and highlight their efficacy of wound repair and regeneration. Near-infrared (800–830 nm) was found to be the most effective and widely studied wavelength range followed by red (630–680 nm) and 904 nm superpulsed light exhibiting beneficial photobiomodulatory effects on impaired dermal wound healing.

Background Burn wound healing is delayed due to several critical factors such as sustained inflammation, vascular disorder, neuropathy, enhanced proteolysis, infection, and oxidative stress. Burn wounds have limited oxygen supply owing to compromised blood circulation. Hypoxic burn milieu leads to free radicals overproduction incurring oxidative injury, which impedes repair process causing damage to cell membranes, proteins, lipids, and DNA. Photobiomodulation (PBM) with 904 nm superpulsed laser had shown potent healing efficacy via attenuating inflammation while enhancing proliferation, angiogenesis, collagen accumulation, and bioenergetic activation in burn wounds. Methods This study investigated the effects of 904 nm superpulsed laser at 0.4 mW/cm2 average power density, 0.2 J/cm2 total energy density, 100 Hz frequency, and 200 ns pulse width for 10 min daily for seven days postburn injury on nitroxidative stress, endogenous antioxidants status, and redox homeostasis. Results Photobiomodulation treatment significantly decreased reactive oxygen species, nitric oxide, and lipid peroxidation levels as compared to non-irradiated control. Further, protective action of PBM against protein oxidative damage was evidenced by reduced protein carbonylation and advanced oxidation protein product levels along with significantly enhanced endogenous antioxidants levels of SOD, catalase, GPx, GST, reduced glutathione, and thiol (T-SH, Np-SH, P-SH). Biochemical changes aid in reduction of oxidative stress and maintenance of redox homeostasis, which further well corroborated by significantly up-regulated protein expression of Nrf 2, hemeoxygenase (HO-1), and thioredoxin reductase 2 (Txnrd2). Conclusion Photobiomodulation with 904 nm superpulsed laser led to reduction of nitroxidative stress, induction of endogenous antioxidants, and maintenance of redox homeostasis that could play a vital role in augmentation of burn wound healing.

“RED TACTON” is a new technology of transferring data. It is a different technical approach as it does not use electromagnetic waves or infrared technology to transfer data. So what does it use? It uses surface of Human Body or any conducting substance like conductors and dielectrics to transfer data using the weak electric field of the body. It is more secure way of communication than Bluetooth and Wi-Fi as it works on the Principle of Point-to-Point network and require a physical connection to transmit data .With the help of this technology the communication can be done by just a touch or by one step. Our proposed methods are using Biosensors at the receiving device and implementing an Applet at the time of sending or receiving the message for more secure communication. It is currently in testing and developing stage in NTT lab JAPAN. In this paper we are analysing the working principles Functional potential and different applications of “RED TACTON” as a “Human Area Network”.

There is a lot of buzz around the market regarding crypto currencies but no one hardly knows what’s the technology behind it so we are talking about blockchain or the Next Generation Internet as many professionals refers it. Blockchain the recent revolutionizing technology of the IT sector right now and experts are taking a lot of interest in knowing this technology and the reason for the interest in Blockchain is its central attributes that provide security, anonymity and data integrity without any third party organization in control of the transactions, and therefore it creates interesting research areas, especially from the perspective of technical challenges and limitations finding its application all over the different industries. Although it has many applications in different fields such as Banking, Government and Healthcare etc. but we will be focusing on how blockchain can help us in transforming our legal system. In this paper we will discuss some of the basic problems that are faced by the system and due to which many persons face serious problems which in turn are really affecting their lives. So we are proposing an idea that how with the help of blockchain we can somehow lessen the burden of some authorities and helping them in a way possible we have built a small prototype which will basically explain what we are trying to do in this system.

Robotic-assisted total hip arthroplasty (THA) is a recent platform introduced to decrease the risk of malpositioned components. The goals of this study were to determine whether intraoperative data on robotic-assisted THA acetabular component position accurately predict postoperative radiographic acetabular component position and to determine whether intraoperative data on robotic-assisted THA leg length and offset accurately predict postoperative radiographic leg length and offset data. In 146 patients, pre- and postoperative radiographs and intraoperative component measurements were reported for acetabular inclination, anteversion, leg length change, and offset change. Component position obtained by the robotic system and radiographic data were compared with subgroup analysis for the posterior and direct anterior approaches. The average difference between groups was 3.3°±3.1° for inclination, 2.9°±2.3° for anteversion, 3.0±2.3 mm for leg length change, and 4.0±3.1 mm for change in global offset. Correlation between the robotic system and postoperative radiographs was within 10° for 95.9% of cases for inclination and 99.3% for anteversion. Posterior approach correlation was within 10° for 97.1% of cases for inclination and 100% for anteversion. Anterior approach correlation was within 10° for 92.7% of cases for inclination and 97.6% for anteversion. Intraoperative data on component position obtained from the robotic system compared well with radiographic data on component position. Surgeons must remain vigilant to ensure outliers related to robotic system malfunction do not occur. [ Orthopedics. 2016; 39(3):193–199.]

To evaluate clinical outcomes, pain, and patient satisfaction following revision hip arthroscopy with a minimum 2-year follow-up.From April 2008 to October 2011, data were prospectively collected on all patients undergoing revision hip arthroscopy. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures: the modified Harris hip score (mHHS), nonarthritic hip score (NAHS), hip outcome score-activities of daily living (HOS-ADL), and hip outcome score-sport-specific subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS). Patient satisfaction was measured on a scale from 0 to 10. The number of patients who underwent subsequent revision arthroscopy or total hip arthroplasty during the study period is also reported.Eighty-seven patients underwent revision hip arthroscopy during the study period. Seventy (80.5%) patients were included in our study. Average follow-up time was 28 months (range, 20 to 47.4 months). In terms of residual femoroacetabular impingement morphology, 45.7% of patients had preoperative alpha angles ≥ 55°, and 7.14% of patients had a lateral center-edge angle ≥ 40°. The score improvement from preoperative to 2-year follow-up was 57.84 to 73.65 for mHHS, 62.79 to 83.04 for HOS-ADL, 37.33 to 54.93 for HOS-SSS, and 55.65 to 70.79 for NAHS. VAS decreased from 6.72 to 4.08. All scores demonstrated statistically significant improvement (P.001). Overall patient satisfaction was 7.67. Our success rate was 74.58%. Ten (14.29%) patients underwent total hip arthroplasty during the study period. Our hip survivorship was 85.7%. Five (7.14%) patients underwent secondary revision hip arthroscopy during the study period. We found an overall minor complication rate of 10%.Revision hip arthroscopy for all procedures performed on aggregate has improved clinical outcomes for all PROs, high survivorship, and high patient satisfaction scores at short-term follow-up. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty and the potential for revision surgery.Level IV retrospective case series.

With studies indicative of altered drug metabolism and pharmacokinetics (DMPK) under high altitude (HA)-induced hypobaric hypoxia, consideration of better therapeutic approaches has continuously been aimed in research for HA related illness management. DMPK of drugs like ibuprofen may get affected under hypoxia which establishes the requirement of different therapeutic dose regimen to ensure safe and effective therapy at HA. This study examined the effects of the chronic hypobaric hypoxia (CHH) on hepatic DMPK of ibuprofen in rats. Experimental animals were exposed to simulated altitude of 7620 m (∼25,000 ft) for CHH exposure (7 or 14 days) in decompression chamber and administered with ibuprofen (80 mg/kg, body weight, p.o.). Results demonstrated that CHH significantly altered PK variables of ibuprofen and activities of both phase-I and II hepatic metabolic enzymes as compared to the animals under normoxic conditions. Hepatic histopathological observations also revealed marked alterations. Increase in pro-inflammatory cytokines/chemokines viz. IL-1β, IL-2, IFN-γ, TNF-α exhibited close relevance with diminished CYP2C9 expression under CHH. Moreover, the down-regulated CYP2C9 level further supported the underlying mechanism for reduced metabolism of ibuprofen and as a result, increased retention of parent drug in the system. Increased mean retention time, Vd, T½ of ibuprofen, and decreased AUC, Cmax and clearance during CHH further strengthened the present findings. In conclusion, CHH exposure significantly affects hepatic DMPK of ibuprofen, which may further influence the usual therapeutic dose-regimen. Further, there is requirement of human studies to evaluate their susceptibility toward hypobaric hypoxia.

Potential benefits of RF-based technologies have immensely been tapped in diversified fields of military and commercial sectors like radar, telecommunication, defence strategic systems, meteorology, etc. Beside salubrious benefits to the society, the adverse effects of RF radiation emitted by RF-assisted devices cannot be ignored. In the present study, we attempted to investigate the effects of 10 GHz microwave (MW) radiation whole-body intermittent exposure of 3 h/ day consecutively for 5 days. Power density delivered was 5 mW/cm2 and SAR calculated ~0.50 W/kg. The present study evaluates the impact of 10 GHz MW on the markers associated with regulation of cell signaling cascade of stress survival defence mechanism like heat shock proteins (HSPs), HIF-1α, and markers associated with inflammation, pain (NFκβ, substance-P receptor). We have found significantly elevated protein expression levels of HIF-1α, HSP-90, 70 and GRP78, however, non-significant increase in NFκβ and Sub-stance-P receptor and HSP 27. There was no change in dorsal skin temperature was observed by IR-thermography after 5 days of 10 GHz MW exposure. Our data thus contributed to understand the biological effects of 10 GHz MW exposure and its plausible mechanisms of interaction with biological entities, particularly skin, at molecular level.

Hydrogen Sulfide (H2S), recently identified as the third endogenously produced gaseous messenger, is a promising therapeutic prospect for multiple cardio-pathological states, including myocardial hypertrophy. The molecular niche of H2S in normal or diseased cardiac cells is, however, sparsely understood. Here, we show that β-adrenergic receptor (β-AR) overstimulation, known to produce hypertrophic effects in cardiomyocytes, rapidly decreased endogenous H2S levels. The preservation of intracellular H2S levels under these conditions strongly suppressed hypertrophic responses to adrenergic overstimulation, thus suggesting its intrinsic role in this process. Interestingly, unbiased global transcriptome sequencing analysis revealed an integrated metabolic circuitry, centrally linked by NADPH homeostasis, as the direct target of intracellular H2S augmentation. Within these gene networks, glucose-6-phosphate dehydrogenase (G6PD), the first and rate-limiting enzyme (producing NADPH) in pentose phosphate pathway, emerged as the critical node regulating cellular effects of H2S. Utilizing both cellular and animal model systems, we show that H2S-induced elevated G6PD activity is critical for the suppression of cardiac hypertrophy in response to adrenergic overstimulation. We also describe experimental evidences suggesting multiple processes/pathways involved in regulation of G6PD activity, sustained over extended duration of time, in response to endogenous H2S augmentation. Our data, thus, revealed H2S as a critical endogenous regulator of cardiac metabolic circuitry, and also mechanistic basis for its anti-hypertrophic effects.

Various systems of military as well as civilian applications are being widely used worldwide, which involve microwave (MW) radiation at X-Band frequency. Besides their innumerable benefits in different areas of commercial and military sectors, increasing scientific evidences have shown that MW exposure may also lead to adverse biological consequence. The present study investigated the effect of 10 GHz MW exposure on skin of experimental rats. The animals were exposed to 10 GHz source in an anechoic chamber for 3 h daily uninterruptedly for 5 consecutive days at constant power density 5.0 mW/cm2. The oxidative stress markers revealed increase levels of free radical generation, lipid peroxidation and advanced oxidation protein products in MW exposed group compared to the sham-exposed group. The antioxidant enzyme SOD was also found to be significantly elevated. Thus, the study showed that 10 GHz MW exposure causes increase in free radical levels and instigated the events of regulation of oxidative stress in rat skin.

10.1 Introduction Wound healing is a dynamic, multifaceted, well-orchestrated, and highly efficient process that should proceed linearly to restore tissue homeostasis in response to injury. Wound repair proceeds through the coordinated integration of biological and molecular events in the extracellular wound micro-environment during four overlapping phases of hemostasis, inflammation, proliferation and tissue remodeling. It includes the migration, adhesion, proliferation, and differentiation of various cell types, i.e., keratinocytes, fibroblasts, macrophages, mesenchymal stem cells, and endothelial cells, and their interaction with different cytokines, growth factors, and extracellular matrix (ECM) molecules. A cascade of healing events begins with the formation of a fibrin clot, which provides protection to the underlying tissues and serves as a provisional matrix through which cells can migrate and acts as a reservoir for growth factors. During inflammation, aggregated platelets release pro-inflammatory cytokines to recruit neutrophils and macrophages at the wound site. These inflammatory cells phagocytose debris and invading micro-organisms, and they also secrete mediators to stimulate the chemotaxis of cell types necessary for the proliferative phase. In the proliferative phase, fibroblasts, keratinocytes, and endothelial and smooth muscle cells migrate through the wound bed and proliferate, leading to re-epithelialization of the denuded surface. They also synthesize and deposit a provisional ECM, form new blood vessels (angiogenesis), and lead to contraction of the wound size. During the final stage, the newly formed granulation tissue is remodeled by the activity of matrix metalloproteinases (MMPs), which are balanced by the action of “tissue inhibitors of metalloproteinases” (TIMPs).

Obese populations present challenges for acetabular cup placement during total hip arthroplasty (THA). This study examines the accuracy of acetabular cup inclination and version in the obese patient with robotic-assisted computer navigation. A total of 105 patients underwent robotic-assisted computer navigation THA with a posterior approach. Groups were divided on body mass index (BMI, kg/m(2)) of30, 30-35, and35. There was no statistical difference between the BMI30 (n=59), BMI 30-35 (n=34) and BMI35 (n=12) groups for acetabular inclination (P=0.43) or version (P=0.95). Robotic-assisted computer navigation provided accurate and reproducible placement of the acetabular cup within safe zones for inclination and version in the obese patient.

Purpose: To detail our early experience using concomitant hip arthroscopy and periacetabular osteotomy (PAO) for the treatment of acetabular dysplasia. Methods: We prospectively collected and retrospectively reviewed the surgical and outcome data of 17 patients who underwent concomitant hip arthroscopy and PAO between October 2010 and July 2013. Preoperative and postoperative range of motion, outcome and pain scores, and radiographic data were collected. Intraoperative arthroscopic findings and postoperative complications were recorded. Results: The group consisted of 3 male and 14 female patients with a mean follow-up period of 2.4 years. Three patients had undergone previous surgery on the affected hip. Chondrolabral pathology was identified in all 17 patients. Twelve patients underwent labral repair, and five patients underwent partial labral debridement. No patient was converted to total hip arthroplasty or required revision surgery at short-term follow-up. All 4 patient-reported outcome scores showed statistically significant changes from baseline to latest follow-up (P < .001). An excellent outcome was obtained in 82% of patients (13 of 16). The lateral center-edge angle averaged 11 � preoperatively and 29 � postoperatively. The acetabular inclination averaged 18 � preoperatively and 3 � postoperatively. The anterior center-edge angle averaged 7 � preoperatively and 27 � postoperatively. At most recent radiographic follow-up, 1 patient had progression of arthritic changes but remained asymptomatic. No other patient showed any radiographic evidence of progression of arthritis. Complications included 3 superficial wound infections, 1 pulmonary embolism, and 1 temporary sciatic neurapraxia. Conclusions: Our initial experience with concomitant hip arthroscopy and PAO has been favorable. We noted that all our patients have evidence of chondrolabral damage at the time of PAO when the joint is distracted and evaluated. All patients in this series had intra-articular pathology treated arthroscopically and showed satisfactory mean clinical improvement. Hip arthroscopy with PAO did not appear to introduce complications beyond the PAO alone. Level of Evidence: Level IV, therapeutic case series.

Purpose To survey surgeons who perform a high volume of hip arthroscopy procedures regarding their operative technique, type of procedure, and postoperative management. Methods We conducted a cross-sectional survey of 27 high-volume orthopaedic surgeons specializing in hip arthroscopy to report their preferences and practices related to their operative practice and postoperative rehabilitation protocol. All participants completed the survey in person in an anonymous fashion during a meeting of the American Hip Institute. Results All surgeons perform hip arthroscopy with the patient in the supine position, accessing the central compartment of the hip initially, using intraoperative fluoroscopy. All surgeons perform labral repair (100%), with the majority performing labral reconstructions (77.8%) and gluteus medius repairs (81.5%). There is variability in the type of anchors used during labral repair. Most surgeons perform capsular closure in most cases (88.9%), inject either intra-articular cortisone or platelet-rich plasma at the conclusion of the procedure (59%), and prescribe a postoperative hip brace for some or all patients (59%). There is considerable variability in rehabilitation protocols. All surgeons routinely prescribe postoperative heterotopic ossification prophylaxis to their patients, with most surgeons (88.9%) prescribing a nonsteroidal anti-inflammatory medication for 3 weeks. Forty percent of the respondents use the modified Harris Hip Score as the most important outcome measure. Conclusions Consistent practices such as use of intraoperative fluoroscopy, heterotopic ossification prophylaxis, and labral repair skills were identified by surveying 27 hip arthroscopy surgeons at high-volume centers. Most of the surgeons performed routine capsular closure unless underlying conditions precluded capsular release or plication. The survey identified higher variability between surgeons regarding postoperative rehabilitation protocols and use of intra-articular pharmacologic injections at the end of the procedure. These data may provide surgeons with a set of aggregate trends that may help guide training, clinical practice, and research in the evolving field of hip arthroscopy.

Background Ehlers-Danlos syndrome (EDS) is a genetic disorder that affects the structural integrity of collagen within the body. This presents clinically as a connective tissue disorder with increased elasticity of joints, muscles, and ligaments. Multiple joints are affected by hypermobility and joint injury is common in these patients. It is estimated that EDS occurs once in every 5,000 births worldwide. Case review This article focuses on reconstruction of the ligamentum teres (LT) of the hip using a tibialis anterior allograft to treat severe instability and pain in a 43 year-old female with EDS. The LT reconstruction was accompanied by labral repair and capsular plication. The patient was assessed pre- and postoperatively using modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADLS), Hip Outcome Score Sports Specific Subscale (HOS-SSS), Non Arthritic Hip Score (NAHS), Visual Analog Scale (VAS), and satisfaction. One year following surgery the patient has reported positive outcomes in terms of pain and instability. Literature review Ligament reconstruction has been reported in patients with Ehlers-Danlos syndrome for shoulders and knees with positive results and restoration of stability. Currently there is a paucity of literature regarding patients with EDS undergoing hip procedures. In addition, reconstruction of the ligamentum teres for hip instability and pain has rarely been reported in a normal patient cohort. Clinical relevance This is the first study to report ligamentum teres reconstruction of the hip in a patient with Ehlers-Danlos syndrome and hip instability. The patient demonstrated satisfactory results 1 year from surgery.

This study compared 2-year clinical outcomes in hip arthroscopy patients treated with microfracture to a matched control group without full-thickness chondral damage.During the study period between June 2008 and July 2011, data were collected on all patients treated with hip arthroscopy who underwent microfracture. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures. Pain was estimated on the visual analog scale (VAS), and satisfaction was measured on a scale from 0 to 10. A matched-pair group of patients who did not undergo microfracture was selected in a 1:2 ratio. Matching criteria were age within 5 years, sex, surgical procedures, and radiographic findings.Average follow-up for the study was 26.66 months (17.29 to 48.89 months). Forty-nine hips were included in the microfracture group and 98 hips were in entered in the nonmicrofracture group, with no significant difference in PRO scores preoperatively between the groups. Both groups had statistically significant postoperative improvement in all scores, and the average amount of change from preoperative to postoperative scores between the 2 groups was not statistically significantly different for any of the PRO scores. Most importantly, there was no statistically significant difference in postoperative PRO scores between the microfracture and control groups. Patient satisfaction was 6.9 for the microfracture group and 7.84 for the nonmicrofracture group, which was statistically significant (P.05). When comparing patients who received acetabular microfracture to those who received femoral microfracture, both groups had similar preoperative and postoperative PRO scores, with no significant difference in the magnitude of change (delta) at final follow-up.Our study found that patients undergoing microfracture during hip arthroscopy did not show a statistically significant difference in PRO scores when compared with a matched-pair control group at an average of 2 years of follow-up. Both groups showed significant improvement in all PRO scores.Level III, matched case-control study.

Purpose The purpose of this prospective comparative study was to evaluate the effect of intraoperative platelet-rich plasma (PRP) injection on the outcomes of patients undergoing hip arthroscopy for labral treatment. Methods During the period from November 2010 through March 2012, all patients undergoing hip arthroscopy for labral tears were considered for this study. The study group received intra-articular PRP at the end of the operation, and the control group received an intra-articular injection of 0.25% bupivacaine. Selection for the study group was based on the day of the week on which the patient underwent surgery. The protocol included administration of 4 hip-specific patient-reported outcome tools. Patients also reported their pain score on a visual analog scale from 0 to 10. Scores were recorded at the preoperative visit and at 3 months and 2 years postoperatively. Results A minimum of 2 years' follow-up was available for 306 patients. Thirteen patients (4.2%) underwent conversion to total hip arthroplasty and 24 patients (7.8%) underwent revision hip arthroscopy, which left 91 patients in the study group and 180 patients in the control group. The study group had slightly higher pain scores than the control group (3.4 v 2.5) 2 years after surgery ( P = .005). No difference in pain scores was identified at 3 months postoperatively. The 2-year modified Harris Hip Score was slightly lower in the study group (78.6) than in the control group (82.6) ( P = .049). No significant difference was observed for the Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sport-Specific Subscale, or Non-Arthritic Hip Score at any time point. There was no significant difference between groups for conversion to total hip arthroplasty or revision surgery. Conclusions On the basis of the results of this study, intraoperative PRP injection does not appear to improve the clinical results of patients undergoing hip arthroscopy for labral treatment. Level of Evidence Level II, prospective comparative study.

Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years.Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures.The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P.001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (Δ) from preoperatively to 2 years postoperatively, there was no significant difference between both groups. The overall survivorship rate was 98.1% for the younger control group and 82.7% for the older study group.Survivors aged 50 years or older show similar improvement to patients aged 30 years or younger in PRO and patient satisfaction scores. The 2-year survivorship rate was 98.1% for the younger control group and 82.7% for the older study group. Therefore we believe that hip arthroscopy should be considered a valid treatment option when treating hip pain in patients aged 50 years or older with a Tönnis arthritic grade of 0 or 1. Older patients should be counseled on the possibility of later conversion to total hip arthroplasty. Future work may include development of a decision-making tool to assess for prognosis to better delineate the indications for hip arthroscopy in the older population.Level III, therapeutic case-control study.

Lateral hip pain along with tenderness of the greater trochanter has been associated with greater trochanteric pain syndrome. Radiographically, this has been associated with gluteus medius pathology on magnetic resonance imaging. This has led some surgeons to conclude that abductor pathology is a primary cause of lateral hip pain. Failure of conservative treatment in the setting of gluteus medius pathology may lead to surgical intervention. In some patients a focal tear of the gluteus medius cannot be visualized and likely represents more diffuse tendinopathy. In these patients we propose micropuncture of the greater trochanter. Similar procedures have shown effectiveness in the elbow and shoulder by eliciting a healing response. Our experience suggests that trochanteric micropuncture at the insertion of the gluteus medius tendon can be effectively performed endoscopically for gluteus medius tendinopathy.

Background: Obesity presents a challenging problem in surgical treatment and has led to poorer postoperative outcomes. The purpose of this study was to evaluate whether hip arthroscopy in the obese patient influences postoperative clinical and patient-reported outcome scores. Methods: From February 2008 to February 2012, data were collected prospectively on all patients undergoing primary hip arthroscopy. A total of 680 patients were included. All patients were assessed preoperatively and postoperatively with four patient-reported outcome measures. Pain was estimated on the visual analog scale. The patient satisfaction score was measured. Three groups were stratified by body mass index. The non-obese group, those with a body mass index of

There are no reports examining the learning curve during the adoption of robotic assisted THA. The purpose of this study was to examine the learning curve of robotic assisted THA as measured by component position, operative time, and complications. The first 105 robotic-assisted THAs performed by a single surgeon were divided into three groups based on the order of surgery. Component position, operative time, intra-operative technical problems, and intra-operative complications were recorded. There was a decreased risk of acetabular component malpositioning with experience (P

Educational Objectives As a result of reading this article, physicians should be able to: 1. Discuss the kinematic relationship between the hip and lumbar spine. 2. Explain the innervation of the hip and lumbar spine and how they relate to one another. 3. Recognize the effect of hip disease on the lumbar spine in an athletic population, prior to the onset of degenerative changes. 4. Describe an algorithm for diagnosis and treatment of patients who present with concomitant hip and lumbar spine pain. The hip and lumbar spine are closely related and can create similar patterns of pain and dysfunction. Diagnosis and treatment of hip and spine–related conditions can be challenging due to symptom overlap. Successful evaluation and treatment of hip and lumbar spine conditions requires a thorough understanding the hip-spine connection. Historically the hip-spine connection has been considered in the context of arthrosis; however, the hip-spine connection also needs to be considered in a younger athletic population. The purpose of this review is to describe the hip-spine connection, discuss the clinical implications of this connection, and offer an approach to diagnosis and treatment. [ Orthopedics. 2015; 38(1):49–55.]

Purpose: The purpose of this study was to investigate the influence of multiple demographic and radiographic findings on the size of labral tears identified at the time of hip arthroscopy. Methods: Data were prospectively collected for patients treated with arthroscopic labral repair or debridement from February 2008 to August 2011. Preoperative radiographic and demographic data were collected for 392 patients during the study period. Exclusion criteria included revision surgery and previous hip conditions. An anteroposterior pelvic view, 45 � Dunn view, and false-profile view were used to measure Tonnis grade, neck-shaft angle, alpha angle, lateral center edge angle (LCEA), anterior center edge angle (ACEA), acetabular inclination, and the extent of crossover sign when present. At the time of surgery, labral tear size and location were documented for all patients, using traditional acetabular clock face nomenclature for sizing. A multiple linear regression analysis was then performed to assess the correlation of radiographic and demographic findings with the size of the labral tear. Results: Regression analysis displayed statistical significance for sex (P < .0001), age (P < .0001), and alpha angle (P ¼ .005) with labral tear size. For female patients, Tonnis grade (P ¼ .0004) and neck-shaft angle (P ¼ .004) correlatedwithlabraltearsize.Thismodelaccountedforonly26%ofvariationinlabraltearsize.Conclusions: Preoperative risk factorsfortheextentoflabraltearsizearemalesex, increasingage, and increasingalphaangle.Labraltearswerelargerin female patients with higher Tonnis grades and lower neck-shaft angles. Measurements of acetabular coverage and version showed no correlation with labral tear size. The majority of labral tear size variation was not accounted for in this model. Level of Evidence: Level IV, therapeutic case series.

Hydrogen Sulfide (H2S), recently identified as the third endogenously produced gaseous messenger, is a promising therapeutic prospect for multiple cardio-pathological states, including myocardial hypertrophy. The molecular niche of H2S in normal or diseased cardiac cells is, however, sparsely understood. Here, we show that β-adrenergic receptor (β-AR) overstimulation, known to produce hypertrophic effects in cardiomyocytes, rapidly decreased endogenous H2S levels. The preservation of intracellular H2S levels under these conditions strongly suppressed hypertrophic responses to adrenergic overstimulation, thus suggesting its intrinsic role in this process. Interestingly, unbiased global transcriptome sequencing analysis revealed an integrated metabolic circuitry, centrally linked by NADPH homeostasis, as the direct target of intracellular H2S augmentation. Within these gene networks, glucose-6-phosphate dehydrogenase (G6PD), the first and rate-limiting enzyme (producing NADPH) in pentose phosphate pathway, emerged as the critical node regulating cellular effects of H2S. Utilizing both cellular and animal model systems, we show that H2S-induced elevated G6PD activity is critical for the suppression of cardiac hypertrophy in response to adrenergic overstimulation. We also describe experimental evidences suggesting multiple processes/pathways involved in regulation of G6PD activity, sustained over extended duration of time, in response to endogenous H2S augmentation. Our data, thus, revealed H2S as a critical endogenous regulator of cardiac metabolic circuitry, and also mechanistic basis for its anti-hypertrophic effects.

Background: Arthroscopic acetabuloplasty was initially described with detachment of the labrum to access the acetabular rim for resection, followed by labral refixation. Recent technical improvements have made it possible to perform acetabuloplasty and labral refixation without labral detachment when the chondrolabral junction is intact. Purpose: To compare outcomes for patients undergoing arthroscopic acetabuloplasty and labral refixation without labral detachment (study group), as well as compare this with a group of patients who underwent acetabuloplasty with labral refixation and labral detachment (control group) with a minimum 2-year follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: During the study period, data were prospectively collected on all patients treated with hip arthroscopy. Inclusion criteria for the study group were acetabuloplasty and labral refixation without detachment, performed in cases with an intact chondrolabral junction. Patients were then compared with a control group of patients who had acetabuloplasty with labral detachment and refixation. All patients were assessed pre- and postoperatively using 4 patient-reported outcome (PRO) measures and a visual analog scale (VAS) for pain, as well as monitored for revision surgery. Results: In the study group, the preoperative to postoperative score changed from 64.2 to 86.6 for modified Harris Hip Score (mHHS), 60.5 to 83.8 for Nonarthritic Hip Score (NAHS), 65.3 to 87.3 for Hip Outcome Score–Activity of Daily Living (HOS-ADL), 45 to 75.1 for Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), and 5.7 to 2.6 for VAS. In the control group, the preoperative to postoperative score changed from 61.2 to 84.4 for mHHS, 59 to 84 for NAHS, 62.7 to 86.2 for HOS-ADL, 40.1 to 74.1 for HOS-SSS, and 6.3 to 2.8 for VAS. There was no difference between preoperative and postoperative PRO scores. The preoperative VAS score was lower in the study group than in the control group ( P = .04). The control group demonstrated larger mean preoperative anterior center edge angles (ACEA) (33.8° vs 29.5°) and mean alpha angles (60.5° vs 53.5°) than the study group ( P < .05). There was no statistically significant difference in the change in PRO or VAS scores between groups. Both groups demonstrated significant improvement from preoperative to 2-year follow-up for all 4 PRO scores ( P < .05) and decrease in VAS ( P < .05). One patient in the study group converted to total hip arthroplasty. Seven patients underwent revision hip arthroscopy in the study group, and 8 patients in the control group underwent revision hip arthroscopy. There was no difference in revision rates between groups. Conclusion: Treatment of pincer- and combined-type impingement with arthroscopic acetabuloplasty and labral refixation without detachment, when possible, resulted in similar patient outcomes compared with acetabuloplasty with labral detachment. We may conclude that in cases where the chondrolabral junction remains intact, acetabuloplasty and labral refixation without detachment is a viable option.