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Review
. 2023 Nov 1;8(11):792-797.
doi: 10.1530/EOR-21-0068.

Adhesions in the setting of hip arthroscopy

Joseph J Ruzbarsky  1   2 , Rui W Soares  3 , Spencer M Comfort  1 , Justin W Arner  4 , Marc J Philippon  1   2
Affiliations
Review

Adhesions in the setting of hip arthroscopy

Joseph J Ruzbarsky et al. EFORT Open Rev. .

Abstract

With the growing number of primary arthroscopies performed, patients requiring revision hip arthroscopies for various issues is high including postoperative adhesion formation, a source of pain, mechanical symptoms, range of motion limitation, stiffness, and microinstability. Adhesions are a consequence of biological pathways that have been stimulated by injury or surgical interventions leading to an increased healing response. Preventative efforts have included surgical adjuncts during/after primary hip arthroscopy, biologic augmentation, and postoperative rehabilitation. Treatment options for adhesion formation includes surgical lysis of adhesions with or without placement of biologic membranes aimed at inhibiting adhesion reformation as well as systemic medications to further reduce the risk. Postoperative rehabilitation exercises have also been demonstrated to prevent adhesions as a result of hip arthroscopy. Ongoing clinical trials are further investigating pathways and prevention of adhesion formation.

Keywords: adhesions; arthrofibrosis; hip arthroscopy; hip pain; stiffness.

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Conflict of interest statement

MJP receives royalties from Smith + Nephew, Inc., Arthrosurface, Bledsoe, ConMed Linvatec, DJO, SLACK Inc., and Elsevier; owner/shareholder in Arthrosurface, MJP Innovations LLC, Vail Valley Surgery Center, Vail MSO Holdings LLC; Shareholder in MIS, EFFRx, Olatec, iBalance (Arthrex), Manna Tree Partners, Stryker, Trimble, 3M, Bristol Myers, Squibb, Pfizer, AbbVie, Johnson & Johnson; and Board Member for the International Society of Hip Arthroscopy, Vail Health Services and Co-Chairman for the Steadman Philippon Research Institute. MJP has also received education support from Smith + Nephew, Inc., ConMed Linvatec, Ossur, Arthrex, Siemens Medical Solutions; speaking fees and consulting from Smith + Nephew, Inc., MIS, Olatec, NICE Recovery Systems; and hospitality payments from Siemens Medical Solutions and Synthes GmbH. JJR is a consultant for Smith + Nephew, Inc. RWS, SMC, JWA having nothing to disclose.

Figures

Figure 1
Figure 1
Arthroscopic view of right hip demonstrating capsulolabral adhesions. A, adhesions; AC, acetabular cartilage; C, capsule; FH, femoral head; L, labrum.
Figure 2
Figure 2
Surgical treatment algorithm for capsulolabral adhesions during revision hip arthroscopy.
See this image and copyright information in PMC

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