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Catastrophic Failure of Hip Arthroscopy Due to Iatrogenic Instability: Can Partial Division of the Ligamentum Teres and Iliofemoral Ligament Cause Subluxation?

Published:February 10, 2012DOI:https://doi.org/10.1016/j.arthro.2011.12.005

      Abstract

      Hip arthroscopy is an evolving surgical tool, and with any new procedure, it is important to learn from the complications encountered. A patient with mild hip dysplasia and a symptomatic labral tear underwent uneventful hip arthroscopy and labral repair including partial debridement of a hypertrophied ligamentum teres. Despite preservation of the labrum, no pincer resection, and a modest capsulotomy, 3 months, subluxation and joint space narrowing were noted. One year, end-stage arthritis was present, requiring total hip replacement. Instability after hip arthroscopy is due to a number of factors, including excessive rim trimming, capsulotomy, overzealous labral resection, or inadequate labral repair. This report emphasizes the importance of the ligamentum teres and small disruptions of the capsule in patients with mild dysplasia.
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      Linked Article

      • Hip Arthroscopy Catastrophic Failure: What Happened to the Joint?
        ArthroscopyVol. 28Issue 7
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          I read with great interest and attention the recent article by Mei-Dan et al.1 regarding a dysplastic hip treated arthroscopically that rapidly progressed to osteoarthritis with joint subluxation. I found that the evolution described by the authors corresponded to the figures presented in the article and that the diagnosis was perfect. The tables and the Discussion section were well prepared and bring many relevant aspects to the reader. However, I would like to discuss possible causes of the progression because I believed that some key aspects may have been overlooked by the authors.
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